Abstract
BackgroundTo estimate the effect of strabismus (squinting) on mental health and health-related quality of life aspects in children and adolescents.MethodsData from the German Health Interview and Examination Survey for Children and Adolescents KiGGS (2003–2006 baseline survey; N = 14,835, aged 3 to 17 years, 49% girls) were examined. The presence of strabismus was derived by parental questionnaire, and health-related quality of life and mental health were investigated with the KINDL-R and Strengths and Difficulties Questionnaire. Associations between strabismus and outcomes were analyzed using multivariable linear and logistic regression models.ResultsOf 12,989 children without missing data, 579 children (4.5% of the sample) were reported to have strabismus. Children with strabismus had lower scores in the parent-reported KINDL-R total scale (adjusted beta = − 1.02; 95%CI: -1.86 to − 0.18; p = 0.018) and sub-scale ‘friends’ (adjusted beta = − 2.18; 95%CI: -3.56 to -0.80; p = 0.002) compared to children without strabismus. The presence of strabismus was also associated with more mental health problems like ‘hyperactivity/inattention’ (adjusted OR = 1.50; 95%CI: 1.14 to 1.98; p = 0.005), and ‘peer problems’ (adjusted OR = 1.35; 95%-CI: 1.05 to 1.74; p = 0.018) as reported by parents.ConclusionsStrabismus in children and adolescents is associated with lower health-related quality of life.
Highlights
To estimate the effect of strabismus on mental health and health-related quality of life aspects in children and adolescents
With respect to health-related quality of life scales and mental health problems, missing data in parental reports were associated with migrant status and living in cities as well as missing data for other covariates (Additional file 4: Table S4)
Missings in self-reported health related quality of life were associated with migrant status, the presence of chronic disease, and having an official disability (Additional file 5: Table S5)
Summary
To estimate the effect of strabismus (squinting) on mental health and health-related quality of life aspects in children and adolescents. People with strabismus (squinting) may confuse other people due to the deviating position of one eye [1, 2], and the vis-à-vis may not be able to determine which eye is fixating. People with strabismus often do not look others in the eye. Manifestation of strabismus may lead to lower self-esteem [3] and potentially impacts activities of daily life and social participation. A recent population-based study in the U.S reported that general health-related quality of life is lower in preschool children having strabismus compared to children without strabismus [5]. To overcome the miss-alignment of both eyes, strabismus surgery can be performed. The re-alignment does not lead to stereopsis in most cases, but rather reconstructs the face appearance
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