Specific Health-Related Quality of Life Concerns in Children with Intermittent Exotropia

Abstract

Purpose To assess the frequency of specific health-related quality of life (HRQOL) concerns in children with intermittent exotropia (XT) using the Intermittent Exotropia Questionnaire (IXTQ). Methods 80 children with intermittent XT (aged 5 to <17 years), plus one parent for each child, completed the Child and Proxy IXTQ respectively. Each item was scored from 0 to 100 (worst to best HRQOL). Mean scores were calculated for each item and items were ranked from lowest to highest impact (worst HRQOL). Analysis was repeated for sub-groups of 5- to <8- (n=46) and 8- to <17- (n=34) year olds. Results Highest impact Child IXTQ items were: “It bothers me that I have to shut one eye when it is sunny,” “I worry about my eyes,” and “It bothers me because I have to wait for my eyes to clear up.” Highest impact Proxy IXTQ items were: “It bothers my child because he/she has to shut one eye when it is sunny” and “My child worries about his/her eyes.” Lowest impact Child and Proxy items were “My eyes make it hard to make friends,” and “Kids tease me because of my eyes.” Ranking of items was similar for younger and older children. Conclusions The greatest HRQOL concerns for children with intermittent XT were shutting one eye when sunny, waiting for their eyes to clear up, and worrying about their eyes. Items related to teasing and making friends were of least concern. Evaluation of HRQOL concerns using the IXTQ may be helpful in the clinical care of individual patients.

Childhood intermittent exotropia from a different angle: does severity affect quality of life?

“…Furthermore, out of the items in the IXTQ, children with IXT were most bothered by the need to shut one eye in the sun and waiting for the eyes to clear up. Teasing and difficulty making friends were of least concern, in line with other studies that showed a surprising lack of teasing and bullying in children with strabismus 18. It is perhaps not surprising then that clinical measurements such as poorer control and larger angle of deviation which are more likely to lead to social bias are not necessarily correlated with poorer child IXTQ scores.…”

Health-related quality of life correlated with the clinical severity of intermittent exotropia in children

“…Even the questionnaires for quantifying HRQOL in childhood intermittent exotropia, e.g., "shutting one eye when sunny, waiting for their eyes to clear up, and worrying about their eyes", were designed to be clinically relevant [11,12]. However, few studies have evaluated the correlation between the severity of intermittent exotropia and HRQOL.…”

The health-related quality of life and anxiety for childhood intermittent exotropia before and after surgical correction

“…Especially, younger children, who have not yet to form a clear aesthetic concept and an established awareness of their eye disease. Essentially, strabismus is their norm and has little effect on their daily life [26] . Moreover, exotropia in children with IXT appears intermittently, which may also make it di cult for them to consistently respond to this condition and would thus not always affect their quality of life.…”