Br J Ophthalmol doi:10.1136/bjo.2010.185793
  • Clinical science

Strabismus and discrimination in children: are children with strabismus invited to fewer birthday parties?

Press Release
  1. Daniel Stéphane Mojon2,3
  1. 1Research Institute for Labour Economics and Labour Law, University of St Gallen, St Gallen, Switzerland
  2. 2Department of Strabismology and Neuro-Ophthalmology, Kantonsspital, St Gallen, Switzerland
  3. 3University of Bern, Bern, Switzerland
  1. Correspondence to Dr Daniel S Mojon, Department of Strabismology and Neuro-Ophthalmology, Kantonsspital, 9007 St Gallen, Switzerland; daniel.mojon{at}
  1. Contributors SMM-A participated in the conception, design, data analysis and interpretation of the data; she drafted the manuscript and critically revised it, and participated in the statistical analysis. AK participated in the conception and design of the study, collected the data and critically revised the manuscript. DSM participated in the conception and design, data analysis and interpretation of the data; he critically revised the manuscript and participated in the statistical analysis.

  • Accepted 27 June 2010
  • Published Online First 18 August 2010


Aim To determine the social acceptance of children with strabismus by their peers and to determine the age at which the negative impact of strabismus on psychosocial interactions emerges.

Methods Photographs of six children were digitally altered in order to create pictures of identical twins except for the position of the eyes (orthotropic, exotropic and exotropic) and the colour of the shirt. One hundred and eighteen children aged 3–12 years were asked to select, for each of the six twin pairs, one of the twins to invite to their birthday party. The grouping of the pictures and the composition of the twin pairs were determined by Latin squares.

Results Children younger than 6 years old did not make any significant distinctions between orthotropic children and children with strabismus. Respondents aged 6 years or older invited children with a squint to their birthday parties significantly less often than orthotropic children. The authors found no impact (p>0.1) of gender, of the colour of the shirt or of the type of strabismus, but did find a highly significant impact of age on the number of invited children with strabismus.

Conclusions Children aged 6 years or older with a visible squint seem to be less likely to be accepted by their peers. Because this negative attitude towards strabismus appears to emerge at approximately the age of 6 years, corrective surgery for strabismus without prospects for binocular vision should be performed before this age.


  • Competing interests None.

  • Patient consent Obtained from the parents.

  • Ethics approval Ethics approval was provided by the Ethics Commission of the Canton St Gallen.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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