Binocular inhibition in strabismic patients is associated with diminished quality of life

Tandon, Anika; Velez, Federico G.; Isenberg, Sherwin J.; Demer, Joseph L.; Pineles, Stacy L.

doi:10.1016/j.jaapos.2014.05.009

Cited by 17 publications

(16 citation statements)

References 16 publications

(29 reference statements)

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“…In our study, patients who recovered binocular function after surgery had better scores than those without binocular function in both subscales. The above finding is also supported by a previous report that patients without binocular inhibition had better HRQOL than those with inhibition[11]. …”

Section: Discussionsupporting

confidence: 87%

“…In patients with strabismus, the factors affecting patient HRQOL are related to strabismus characteristics[9–11]; demographics[12]; psychosocial parameters, such as mood, depression, and self-esteem; and understanding of strabismus[13–15]. HRQOL can be improved after corrective surgery in both the short term (6 weeks to 90 days) and long term (1 year to 18 months),as assessed via the Adult Strabismus-20 (AS-20), the Amblyopia and Strabismus Questionnaire (A&SQ), and other generic questionnaires[16–21].…”

Section: Introductionmentioning

confidence: 99%

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Long-Term Quality of Life in Adult Patients with Strabismus after Corrective Surgery Compared to the General Population

Chen

et al. 2016

PLoS ONE

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PurposeTo evaluate the status of and factors associated with long-term health-related quality of life (HRQOL) in adult patients with strabismus following corrective surgery.MethodsProspective cross-sectional study. A total of 122 adults who underwent corrective surgery and were followed up for at least 1 year were recruited. Pre- and post-operative HRQOL were evaluated using the Chinese version of the Adult Strabismus 20 (AS-20). Demographics and clinical characteristics were recorded. Eighty-nine age-matched, normal individuals without a history of strabismus were recruited as a control group.ResultsAS-20 scores improved significantly in the psychosocial subscale and total scale after surgery for all122 patients, but not in the function subscale. HRQOL was better in the successful cases than in the non-successful cases (p<0.005). Subjects who recovered stereo function had better HRQOL than those who did not (p<0.01). Compared to the control population, the patients had poorer HRQOL post-operatively, with only approximately 30% of the subjects having scores within the normal threshold scores. The self-sense of a lack of ocular deviation and a successful surgical outcome were significant factors associated with post-operative HRQOL status.ConclusionsHRQOL, as evaluated by AS-20 scores, improved in the patients after surgery but was worse than that in the general population. Successful surgical outcomes and a sense of good alignment were the main factors that correlated with increased post-operative HRQOL. Positive assessments of surgical results by patients may benefit post-operative HRQOL.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Long-Term Quality of Life in Adult Patients with Strabismus after Corrective Surgery Compared to the General Population

Chen

et al. 2016

PLoS ONE

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“…We have shown that strabismic patients have subnormal binocular summation, and even binocular inhibition (worse visual function with binocular compared to monocular viewing) and this is associated with diminished quality of life. 19, 20 Our findings suggest that diplopia and other factors affecting vision in strabismic patients may have a greater impact on visual functioning than factors affecting vision in the other ocular diseases studied.…”

Section: Discussionmentioning

confidence: 67%

Quality of Life in Adults With Strabismus

Chang

Velez

Demer

et al. 2015

American Journal of Ophthalmology

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Purpose To assess relative quality of life in patients with strabismus. Design Retrospective cohort study Methods The 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) was performed in 42 strabismic adults over the age of 50 years at a single institution. Subscale scores were compared with those of patients with other ocular diseases, including diabetic retinopathy, age-related macular degeneration (AMD), glaucoma, cataract, cytomegalovirus (CMV) retinitis, and low vision. Results Median visual acuity was 20/20 (range 20/12.5 to 20/50), and 34 patients (81%) reported diplopia. Strabismic patients performed the same or worse on nearly all vision-related subscales than did patients with diabetic retinopathy, age-related macular degeneration, glaucoma, cataract, and CMV retinitis. Additionally, strabismic patients reported significantly worse ocular pain than all comparison groups before any surgery was performed. Conclusions Strabismus impacts quality of life through both functional and psychosocial factors. Physicians treating strabismic patients should recognize these quality of life issues and address them accordingly.

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“…22 Moreover, decreased binocular summation in strabismic patients is associated with worse quality of life, emphasizing the importance of improving binocularity. 29 Our previous studies, however, deliberately excluded patients with strabismic amblyopia because of known impairment by amblyopia of binocular summation, 11, 28 and it is unknown if amblyopia further degrades binocular summation beyond that due to strabismus alone.…”

Section: Introductionmentioning

confidence: 99%

Decreased Binocular Summation in Strabismic Amblyopes and Effect of Strabismus Surgery

et al. 2017

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Purpose: Binocular summation (BiS) occurs when binocular visual function surpasses that of the better eye alone. We sought to evaluate whether strabismic amblyopia reduces BiS more than strabismus alone, and determine whether BiS improves in strabismic amblyopes after strabismus surgery. Methods: We prospectively recruited 15 patients with strabismic amblyopia who then underwent strabismus surgery. Thirty age-matched normal subjects and 30 non-amblyopic strabismic patients served as controls. Subjects underwent binocular and monocular visual acuity testing on high-contrast Early Treatment Diabetic Retinopathy Study (ETDRS) as well as 2.5% and 1.25% Sloan low contrast acuity (LCA) charts. BiS was calculated as the difference between better eye and binocular scores. Results: Strabismic amblyopes and strabismic controls did not significantly differ in preoperative BiS, but both had subnormal BiS preoperatively on LCA charts. Among 11 strabismic amblyopes with preoperative and postoperative BiS measurements, average postoperative BiS was not significantly different from preoperative. Improved LCA BiS postoperatively occurred in some patients and was associated with measurable preoperative stereoacuity (p = 0.02), older age at strabismus onset (p = 0.02), and larger preoperative angle of strabismus (p = 0.0043). Conclusions: In this preliminary study, strabismic amblyopes experienced subnormal BiS, but amblyopia generally did not further impair BiS beyond that due to strabismus alone. Some strabismic amblyopes experienced improved low-contrast BiS after strabismus surgery. This suggests that further investigations in larger groups of patients should be undertaken to analyze a previously unrecognized functional benefit of strabismus surgery in strabismic amblyopes.

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Binocular inhibition in strabismic patients is associated with diminished quality of life

Cited by 17 publications

References 16 publications

Long-Term Quality of Life in Adult Patients with Strabismus after Corrective Surgery Compared to the General Population

Long-Term Quality of Life in Adult Patients with Strabismus after Corrective Surgery Compared to the General Population

Quality of Life in Adults With Strabismus

Decreased Binocular Summation in Strabismic Amblyopes and Effect of Strabismus Surgery

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