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Denise Satterfield, MD; John L. Keltner, MD; Thomas L. Morrison, PhD

Arch Ophthalmol. 1993;111(8):1100-1105.

Abstract
Objective
To assess the psychosocial implications of growing up with and living with socially noticeable strabismus.

Design
Self-report mailed questionnaire and the Hopkins Symptom Checklist.

Setting
Patients with strabismus who were seen at the University of California, Davis, Medical Center, Department of Ophthalmology, from 1976 to 1989.

Participants
Forty-three female and male subjects aged 15 years or older who had a history of childhood strabismus that was uncorrected or incompletely corrected past the age of 13 years.

Intervention
None.

Main Outcome Measures
Participants' responses to our survey and to the Hopkins Symptom Checklist.

Results
Strabismus had a negative impact on many aspects of our subjects' lives. They report difficulty with self-image, securing employment, interpersonal relationships, school, work, and sports. Furthermore, difficulties encountered did not go away after childhood, rather, the problems encountered by our subjects intensified in the teenage and adult years. Subjects demonstrated generalized higher levels of distress on the Hopkins Symptom Checklist than age- and sexmatched controls (P<.01).

Conclusions
Psychosocial difficulties relating to socially noticeable strabismus are not just a problem for schoolchildren but also for teenagers and adults. Correction of strabismus in the older teenager or adult may offer them improvement in psychosocial functioning, a benefit not previously reported in the literature.

Author Affiliations
From the Departments of Ophthalmology (Dr Satterfield), Ophthalmology, Neurology, and Neurological Surgery (Dr Keltner), and Psychiatry (Dr Morrison), University of California, Davis.

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