Patients with strabismus may suffer from both reduced visual functioning and the psychosocial
effects of ocular misalignment. For adults with strabismus, there is a strong body
of evidence supporting the advantages of surgical restoration of binocular visual
function. However, even in the absence of binocular visual potential, patients may
benefit from reconstructive surgery to restore an aesthetically acceptable ocular
To review the psychosocial implications of strabismus in the adult population and
to summarize the psychosocial impact of surgical correction.
A Medline search (1946–2013) was conducted to identify the psychosocial implications
of strabismus, its effects on employment, and the impact of surgical correction on
strabismic adults using the following keywords: strabismus, surgery, quality of life,
life style, employment/employability effects, job satisfaction, social support/social
isolation/social marginalization, adaptation, stress, depression, family relations,
interpersonal relations, friends, and peer group. The search was limited to patients
older than 18 years and studies published in English. Of the initial 87 articles for
which abstracts were reviewed, 20 studies were of sufficient relevance to be included
in the review.
Eight studies examined the psychosocial impact of strabismus, 2 of which explored
the effect of strabismus on finding partners, and 4 studies examined the effect of
strabismus on employment. These studies examined perceptions of both patients with
strabismus and the general population. Eight studies evaluated the impact of strabismus
surgery. Strabismus was shown to have negative psychosocial functioning and employability
in both patients’ and the public’s perceptions. Surgical correction was associated
with long-lasting improvement in psychological and social functioning.
There is a fairly strong body of evidence in the literature to suggest that adult
strabismus patients suffer significant social, psychological, and economic effects
because of their condition. Surgery can be effective in improving these disadvantages.
Clinicians should be aware of the importance of offering surgery to patients with
significant strabismus, even in patients for whom it is not expected to improve visual