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Childhood intermittent exotropia from a different angle: does severity affect quality of life?
  1. S B Lim1,2,
  2. W L Wong1,3,
  3. R C Ho4,
  4. I B Wong1
  1. 1Department of Ophthalmology, National University Hospital, Singapore
  2. 2University of Cambridge School of Medicine, Cambridge, UK
  3. 3Singapore Eye Research Institute, Singapore
  4. 4Department of Psychological Medicine, National University Hospital, Singapore
  1. Correspondence to Dr Inez B Y Wong, Department of Ophthalmology, National University Hospital, 1E Kent Ridge Road, NUHS Tower Block 7, Singapore 119228; inez_by_wong{at}


Background Few studies have explored the relationship between health-related quality of life (HRQOL) and clinical severity of childhood intermittent exotropia (IXT) measured by angle of deviation, control and stereoacuity.

Methods Sixty-eight consecutive children aged 5–17 years with childhood IXT who attended the paediatric eye clinic were recruited. One accompanying parent was recruited concurrently. Child, parent and proxy (parent about the child) HRQOL was measured using the IXT questionnaire (IXTQ). Angle of deviation, control and stereoacuity of the children were measured and correlated with IXTQ scores using Spearman's correlation coefficient and paired t test for differences in child and proxy IXTQ mean scores.

Results The mean age of the children was 9.0±2.6 years. Child HRQOL was not correlated to any strabismus measurements. Poorer parent HRQOL was correlated with poorer distance control (surgery subscale, r=−0.24 p=0.049), poorer near control (surgery subscale, r=−0.30, p=0.013), poorer office near control (mean, r=−0.24, p=0.047; psychological subscale, r=−0.27, p=0.025; surgery subscale, r=−0.28, p=0.020) and larger angle of deviation (psychological subscale, r=−0.30, p=0.013). Poorer proxy HRQOL was correlated with poorer home control (r=−0.28, p=0.022) and larger angle of deviation (r=0.33, p=0.0061).

Conclusions It is difficult to predict child HRQOL based on clinical measurements. However, parent HRQOL tends to be worse with poorer control and larger angle of deviation. Perhaps HRQOL should be routinely assessed in clinic alongside clinical measurements in order to tailor management appropriately.

  • Child health (paediatrics)
  • Muscles

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