EXTENDED REPORT

The psychosocial benefits of corrective surgery for adults with strabismus

S Jackson¹, R A Harrad², M Morris³ and N Rumsey⁴

¹ Centre for Appearance Research, University of the West of England, Frenchay Campus, Coldharbour Lane, Frenchay, Bristol BS16 1QY, UK
² Bristol Eye Hospital, UK
³ University of the West of England, UK
⁴ University of the West of England, UK

Correspondence to:
Correspondence to:
Sue Jackson
Centre for Appearance Research, University of the West of England, Frenchay Campus, Coldharbour Lane, Frenchay, Bristol BS16 1QY, UK; sue{at}winterbourne.freeserve.co.uk

Background: Few papers have addressed the psychological impact of strabismus in adults, with none comparing preoperative and postoperative data using standardised questionnaires relating surgical results and psychosocial outcomes.

Methods: 46 participants were seen at their 6 week preoperative and 3 month postoperative appointments. Standardised measures of anxiety and depression (Hospital Anxiety and Depression Scale), social anxiety (Derriford Appearance Scale), and quality of life (WHOQoLBref) were completed.

Results: Preoperatively, levels of depression were comparable to relevant population norms; however, levels of general anxiety were slightly raised and levels of social anxiety and social avoidance were significantly poorer than population norms. Surgery resulted in significant improvements in psychosocial adjustment with improvements on all study variables for the participant group as a whole. The non-diplopic group made more significant gains than the diplopic group. Approximately one third of study measures were significantly correlated with the objective measure of eye misalignment preoperatively dropping to only one variable postoperatively. Calculations involving the subjective measure of eye misalignment and study variables showed the opposite pattern with five variables achieving significance postoperatively. There were no clear sex or age effects apparent in the data.

Conclusion: Strabismus surgery offers significant improvements to psychological and physical functioning.

Abbreviations: DAS, Derriford Appearance Scale; HADS, Hospital Anxiety and Depression Scale; PCT, prism cover test; PD, prism dioptres; VAS, visual analogue scales

Keywords: strabismus; surgery; psychosocial; adults

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