Discrepancies between parental reports and clinical diagnoses of strabismus in Korean children
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Published on: March 24, 2020
1Department of Ophthalmology, Ewha Womans University, School of Medicine, Seoul, Korea.
Insights
Parental observation of childhood strabismus (eye misalignment) showed moderate accuracy, correlating with clinical evaluations 67% of the time. Parents were better at detecting outward eye turns (exotropia) than inward ones (esotropia).
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Clinical Evaluation
Background:
- Strabismus is a common condition in children, affecting visual development.
- Accurate and timely diagnosis is crucial for effective treatment.
- Parental observation plays a role in identifying potential eye conditions.
Purpose of the Study:
- To assess the accuracy of parental observations of strabismus compared to formal clinical evaluations in Korean children.
- To determine factors influencing the concordance between parental reports and clinical findings.
Main Methods:
- Retrospective review of medical records for 228 children under 15 with reported horizontal deviation.
- Comparison of parent-reported ocular deviation direction with objective clinical assessment results.
- Analysis of concordance rates based on various clinical and demographic factors.
Main Results:
- Overall concordance between parental observation and clinical evaluation was 67%.
- Lower concordance rates were observed for inward eye deviation (esotropia), younger children, earlier onset, and smaller deviation angles.
- Parental detection of outward eye deviation (exotropia) was more reliable than esotropia.
Conclusions:
- Parental observation of strabismus is a useful but not perfectly accurate screening tool.
- Clinical evaluation remains essential for definitive diagnosis and management of pediatric strabismus.
- Further research may explore methods to improve parental reporting accuracy.
Purpose:
To compare the accuracy of parental observation of strabismus with clinical evaluation in Korean children.
Methods:
The medical records of 228 children <15 years of age who visited the pediatric strabismus clinic from 2002 to 2007 and whose parents reported a horizontal deviation were retrospectively reviewed. We compared subjective parent-reported direction of ocular deviation with the objective results after clinical evaluation.
Results:
The mean age of the 228 children was 3.9 ± 3.0 years. Of these, 178 children (78%) were diagnosed with strabismus; 50 (22%), with orthotropia. The overall concordance rate was 67% (152/228). The concordance rate was lower for parents reporting inward deviation of the eye (P < 0.001), younger age group at presentation (P = 0.004), experienced onset of ocular deviation at younger age group (P = 0.001), and had fewer diopters of deviation (P < 0.001). Patient sex, family history of strabismus, observed frequency of deviation, and laterality of deviated eye did not show statistical differences in concordance rates (all P values >0.05).
Conclusions:
Parental observation correlated with clinical assessment two-thirds of the time. Exotropia was more reliably detected by the parents than esotropia.
