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Association of Pediatric Strabismus and Functional Impairment: A Cross-sectional Nationwide Analysis
Insights
Children with strabismus face significantly higher risks of functional limitations, impacting relationships and behavior. This study highlights the importance of considering functional burden in managing childhood strabismus.
Area of Science:
- Ophthalmology
- Pediatrics
- Psychology
Background:
- Strabismus, a common childhood eye condition, can affect visual development.
- The impact of strabismus on a child's overall functional abilities is not fully understood.
Purpose of the Study:
- To investigate the association between childhood strabismus and functional limitations.
- To identify specific areas of impairment in children with strabismus.
Main Methods:
- Analysis of 201 children (ages 5-17) with strabismus using 1996-2015 Medical Expenditure Panel Surveys.
- Functional impairment assessed via the Columbia Impairment Scale (CIS); a score of 16+ indicated significant impairment.
- Multivariate regression models adjusted for demographic and socioeconomic factors.
Main Results:
- Children with strabismus showed higher rates of clinically significant functional impairment (15.1% vs. 9.1%).
- Strabismus was linked to difficulties in relationships with parents and peers, and behavioral issues at home.
- Impairments were also noted in staying out of trouble, managing nervousness, and engaging in sports/hobbies.
Conclusions:
- Childhood strabismus is associated with a 1.8-fold increased likelihood of functional impairment.
- Specific deficits observed in social interactions, behavior, and extracurricular involvement.
- Functional burden should be a key consideration in strabismus management strategies.
Purpose:
To examine the association of childhood strabismus with functional limitation to identify particular domains of impairment.
Methods:
The authors analyzed 201 children ages 5 to 17 years with strabismus enrolled in the 1996-2015 Medical Expenditure Panel Surveys, representative annual surveys of the U.S.
Population:
Functional impairment was assessed using the Columbia Impairment Scale (CIS), a validated measure of behavioral and psychosocial functioning. A CIS score of 16 or greater defined clinically significant functional impairment. Multivariate regression models adjusted for age, sex, race, ethnicity, household income, geographic location, and insurance type were constructed to examine the association of strabismus diagnosis with overall impairment and individual domains of function.
Results:
Children diagnosed as having strabismus had higher rates of clinically significant functional impairment compared to those without strabismus (15.1% vs 9.1%, adjusted odds ratio [95% CI]: 1.82 [1.11 to 2.97], P = .02). Moreover, strabismus diagnosis was associated with higher rates of problems with getting along with their mother (1.70 [1.21 to 2.40], P = .003) and father (1.66 [1.16 to 2.38], P = .006), getting along with other children (1.67 [1.16 to 2.40], P = .006), behavior at home (1.94 [1.37 to 2.74], P = .0002), staying out of trouble (1.52 [1.04 to 2.23], P = .03), nervousness (1.49 [1.05 to 2.11], P = .02), and getting involved with sports and hobbies (1.55 [1.03 to 2.34], P = .04).
Conclusions:
Childhood strabismus is associated with 1.8-fold greater odds of clinically significant functional impairment, with greater dysfunction in specific relationship and behavioral domains. Functional burden may be an important consideration in management decisions. [.
