A Study on Quality of Life and Self Esteem in children and adolescents with Strabismus

Abstract

Background/Context: Strabismus is a condition that results in loss of self esteem and affects quality of life due to the changes it may cause in facial appearance and other factors. There is a dearth of Indian literature on children and adolescents with strabismus. The current study analyzed self esteem and quality of life in children and adolescents with strabismus. Methods: Children and adolescents between 6-17 years attending the ophthalmology out-patient department of a tertiary general hospital and their normal siblings were identified and assessed after parental consent using a semi-structured proforma and the KINDL questionnaire. The results were statistically analyzed and presented. Results: 35 children and adolescents with strabismus were compared to 38 siblings who were the controls. It was seen that children and adolescents with strabismus scored lower on family and social contacts quality of life scores on all subscales of the KINDL questionnaire. However, self-esteem did not differ across both groups. Conclusion: Further larger studies in diverse populations are needed to corroborate the effects of strabismus on self esteem and quality of life.

Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Quality of Life in Children: A Systematic Review

“…Only 4 studies (9.09 %) were from low-income countries, including 1 each from Iran 54 and Pakistan 25 and 2 from India. 39,57 Twenty-nine studies were from middle-income countries, including 1 each from South Africa 28 and Malaysia, 45 2 from Brazil, 23,33 and 24 from China. 7,19,21,22,24,29,31,32,34,37,38,40,42,44,46,48,49,51e53,55,56,58,59 Twelve studies were from high-income countries, including 1 each from Germany, 35 Japan, 50 Portugal, 41 the United Kingdom, 6 and Korea 26 ; 2 from Singapore 18,36 ; and 5 from the United States.…”

“…The most commonly used tools were the Intermittent Exotropia Questionnaire (n ¼ 12), 30,36,38,40,45e49,52,53,55 the Pediatric QoL Inventory (n ¼ 11), 7,18e21,26,29,33,34,42,51 and the 25-item National Eye Institute Visual Function Questionnaire (n ¼ 7). 21,22,28,31,32,37,44 Other questionnaires included the RAND Health Insurance Study questionnaire, 43,54 the Pediatric Eye Questionnaire, 24,27 the World Health Organization QoL Scale, 25 the QoL Impact of Refractive Correction, 59 the scale of QoL for children with congenital bilateral cataract, 58 a self-developed questionnaire to assess the impact of amblyopia treatment on health-related QoL, 56 the Children's Visual Function Questionnaire, 23 the generic KINDL-R questionnaire, 35,39 the LV Prasad Functional Vision Questionnaire, 57 and the Low Vision QoL Questionnaire. 6 Nine of these instruments were condition specific and 4 were general.…”

“…Four observational studies concerning strabismus were not included in the meta-analysis because of the use of proxy-reported outcomes of QoL. 20,34,39,41 Wang et al 34 found that strabismus and amblyopia had a negative impact on children's daily life, learning, and psychological state. Wen et al 20 associated with a significantly worse QoL in preschool children, whereas no association was found between amblyopia and QoL.…”

“…Two studies did not provide composite QoL scores, although they found that children with strabismus had lower scores in some QoL domains than unaffected children. 39,41 Another study found that children with allergic conjunctivitis had significantly lower total QoL scores than an unaffected control group. 42 Of the 6 interventional studies concerning strabismus not included in the meta-analysis of before-and-after study design, 1 study was an RCT, 52 2 studies lacked original data, 44,50 2 studies failed to report composite QoL scores, 43,54 and 1 study reported only a parent-proxy outcome.…”

“…First, most included studies were conducted in high-income or middle-income countries, with only 4 from low-income countries. 25,39,54,57 Additional evidence from low-income countries would contribute to a more comprehensive understanding of the association between vision impairment or ocular morbidity and QoL in children to inform policymaking. Second, all studies in the meta-analysis concerning the correction of strabismus used a before-and-after design without an untreated control group.…”