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What do patients with strabismus expect post surgery? The development and validation of a questionnaire
  1. Hayley McBain1,2,
  2. Kelly MacKenzie3,
  3. Joanne Hancox3,
  4. Daniel G Ezra3,4,
  5. Gillian GW Adams3,
  6. Stanton P Newman1
  1. 1School of Health Sciences, City University London, London, UK
  2. 2Community Health Newham, East London Foundation Trust, London, UK
  3. 3Department of Strabismus and Neuro-ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  4. 4UCL Institute of Ophthalmology NIHR Biomedical Research Centre for Ophthalmology, London, UK
  1. Correspondence to Professor Stanton Newman, School of Health Sciences, City University London, Northampton Square, London EC1V 0HB, UK; stanton.newman.1{at}


Aims To develop and validate a short questionnaire to assess patients’ expectations about outcomes post strabismus surgery.

Methods Questionnaire items were extracted from previous literature and reviewed by a multidisciplinary team. A cross-sectional study was then undertaken with 220 adult patients due to undergo strabismus surgery. Participants completed the 17-item questionnaire. Scale structure was explored using principal component analysis (PCA), and the subscales analysed in relation to demographic and clinical characteristics and psychosocial well-being in order to establish validity.

Results PCA revealed a 3-factor solution for the Expectations of Strabismus Surgery Questionnaire (ESSQ): (a) intimacy and appearance-related issues, (b) visual functioning, (c) social relationships. This 3-factor solution explained 59.30% of the overall variance in the ESSQ. Internal consistency, content and nomological and concurrent validity were considered acceptable.

Conclusions Patients with strabismus have high expectations about their postsurgical outcomes. This questionnaire provides a useful tool to assess the expectations patients have about their surgery, whether these expectations change over time and how they impact on postsurgical outcomes.

  • Cosmesis
  • Treatment Surgery

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