Health-related quality of life of children with strabismus

PURPOSE: The agreement between children with strabismus and their parents on the health-related quality of life (HRQOL) of the child is unknown. Additionally, it is unknown if physical traits pre-dispose to a better outcome in HRQOL after strabismus surgery in children. This study aims to aid strabismus surgeons in deciding which children will improve HRQOL following strabismus surgery.

METHODS: We included 114 Danish children who underwent strabismus surgery for their strabismus and 29 controls without ophthalmologic manifestations. Each child and their parent answered questionnaires about the child's eye- and general health. We compared eye-specific, psychosocial and physical scores in children pre- and post-operatively with controls. We also investigated child-parent (proxy) agreement and whether sex, age and strabismus type were associated with improvement in HRQOL after surgery.

RESULTS: Children with strabismus scored themselves lower on eye-related HRQOL questions than their parents scored them (p = 0.01). Children with strabismus had similar improvements in HRQOL after surgery independent of age, sex, use of glasses and type of strabismus. Children with strabismus scored lower across all questionnaires on HRQOL even after surgery compared to controls (eye specific, p < 0.001; PedsQL psychosocial = 0.006).

CONCLUSION: Strabismus surgery in children improved their quality of life regardless of sex, age, wearing glasses or strabismus type. The surgeon should be aware of potential discrepancies in perception of the HRQOL of the child, between the child and their parent when making their assessment.