Surgery improves quality of life in adults with childhood-onset strabismus

This prospective study found that adults with childhood-onset constant strabismus who underwent strabismus surgery report improvement in their quality of life and in some cases experience restored binocular sensory function.

The study included 20 consecutive patients with childhood-onset, long-term constant strabismus. They ranged in age from 18 to 63 years. Ten were esotropic and 10 exotropic.

They all underwent surgical treatment. Thirteen of them obtained a satisfactory postoperative alignment and demonstrated an increase of sensory status with the Bagolini striated glasses test. Six patients who demonstrated suppression preoperatively achieved fusion and stereopsis postoperatively.

The mean score in all domains of the Amblyopia and Strabismus Questionnaire (A&SQ) improved significantly, particularly with regard to social contact and cosmesis, distance estimation and visual disorientation. Similarly, the mean score in seven of eight areas on the Short Form Healthy Survey (SF-36) improved significantly, particularly with regard to physical function, general health, vitality, social function and mental health. The overall mean score on both questionnaires improved in all patients with a satisfactory postoperative alignment and increase in sensory status.

Patients with an unsatisfactory postoperative alignment presented no changes of sensory status and an overall mean score unvaried on both the SF-36 and A&SQ questionnaires.

The authors conclude that these findings suggest that surgical treatment in adults with strabismus, even when the restoration of binocular vision is unlikely, may significantly improve health-related quality of life and, in many cases, binocular function.