Original article
The Effects of Strabismus on Quality of Life in Adults

https://doi.org/10.1016/j.ajo.2007.06.032Get rights and content

Purpose

As a first step in the development of a health-related quality of life (HRQOL) instrument, we conducted in-depth interviews to identify the specific concerns of adults with strabismus.

Design

Prospective cross-sectional study.

Methods

Thirty adults with strabismus, 17 with diplopia, and 13 without were recruited. Individual interviews, using 11 open-ended questions, were audiotaped, transcribed, and transcripts reviewed independently by three investigators. Phrases regarding how strabismus affected everyday life were grouped into topic areas and the frequency of each topic analyzed for subjects with and without diplopia.

Results

A total of 1,508 phrases were extracted: 207 (14%) of 1,508 were excluded because they did not pertain to HRQOL. From the remaining 1,301 phrases, 48 topic areas were apparent. For patients with diplopia, the most frequently occurring topics were: nonspecific negative feeling (15/17; 88%) (“really hard”); general disability (15/17; 88%) (“affects everything”); and driving (14/17; 82%). In those without diplopia, the most frequently mentioned topics were appearance to others (12/13; 92%) (“people notice my eyes”) followed by problems with eye contact (10/13; 77%) and interpersonal relationships (10/13; 77%). Of the topics that were common to both groups (n = 42), two of the most frequent were driving and nonspecific negative feeling.

Conclusions

Multiple individual interviews revealed many topics that negatively affect quality of life in patients with strabismus. The frequency and type of concerns confirm the importance of HRQOL assessment as an important aspect of strabismus management.

Section snippets

Methods

In this prospective cross-sectional study, 30 adult patients (median age, 39.5; range, 18 to 74 years) were recruited from outpatient clinics. All types of strabismus were eligible for inclusion. Seventeen (57%) of the 30 patients had diplopia and 13 (43%) did not. Twenty (67%) were female and all patients self-reported their race as “White.” For the 17 patients with diplopia, diagnoses were: 4th nerve palsy (3), 6th nerve palsy (2), 3rd nerve palsy (2), residual esotropia (2), postretinal

Results

A total of 1,508 phrases were extracted. One hundred and forty-three of the 1,508 phrases were excluded as they did not pertain to HRQOL or referred specifically to distant, historical experiences as a child or the experience of undergoing surgery (e.g., “hard on little kids,” “everyone should have surgery”). An additional 64 phrases were excluded because they were statements of symptoms of diplopia and blurred vision (e.g., “I see two”) without reference to any effects these symptoms had on

Discussion

Strabismus in adults causes a wide range of quality of life concerns; for patients with diplopia the most common issues identified in this study were nonspecific negative feelings, general disability, and driving, whereas for patients without diplopia the most common concerns were appearance to others, eye contact, and interpersonal relationships. Patients with and without diplopia both frequently identified problems with nonspecific negative feelings, driving, and self-esteem. There were some

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