Abstract
Background
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
alignment.
Objective
To review the psychosocial implications of strabismus in the adult population and
to summarize the psychosocial impact of surgical correction.
Methods
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.
Results
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.
Conclusions
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
function.
Résumé
Objectif
Examiner les répercussions psychosociales du strabisme au sein d'une population adulte
et résumer les effets psychosociaux d'une correction chirurgicale.
Méthodes
Une recherche sur Medline (1946–2013) a permis de recenser les répercussions psychosociales
du strabisme, ses effets sur le travail et les conséquences d'une correction chirurgicale
chez des adultes. La recherche se limitait aux sujets d'au moins 18 ans et aux études
publiées en anglais. Sur les 87 articles dont les résumés ont été passés en revue,
on a retenu 20 études qui étaient assez pertinentes pour faire partie de notre revue
de synthèse.
Résultats
Huit études portaient sur les répercussions psychosociales du strabisme, dont 2 études
qui examinaient l'effet du strabisme sur la recherche d'un partenaire de vie et 4
études qui traitaient de l'effet du strabisme sur le travail. Ces études ont exploré
les perceptions des sujets qui présentent un strabisme et celle de la population générale.
Enfin, 8 études ont évalué l'effet d'une correction chirurgicale du strabisme. On
a constaté que la perception du strabisme était négative quant au fonctionnement psychosocial
et à l'employabilité, tant du point de vue des patients que de celui du grand public.
La correction chirurgicale s'accompagnait d'une amélioration durable du fonctionnement
psychologique et social.
Conclusions
L'ensemble de la preuve dans la littérature médicale est suffisamment robuste pour
constater que les adultes qui présentent un strabisme vivent des effets sociaux, psychologiques
et économiques importants en lien avec leur état. La correction chirurgicale peut
contrer efficacement ces désavantages. Les médecins doivent être conscients de l'importance
d'offrir une correction chirurgicale aux patients qui présentent un strabisme important,
même dans les cas où l'on ne s'attend pas à une amélioration de la fonction visuelle.
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Article info
Publication history
Published online: November 08, 2016
Identification
Copyright
© 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
