At What Age Does Strabismus Impact Quality of Life in Children? A Narrative Literature Review

Strabismus can have profound psychosocial impacts in addition to functional impacts. Psychosocial impacts typically stem from negative attitudes and can manifest as low self-esteem, employment discrimination, and problems forming interpersonal relationships. Evidence suggests that negative attitudes towards strabismus emerge in early childhood.The aim of this review was to investigate the age at which strabismus impacts quality of life in children.

A systematic search was conducted using online databases (MEDLINE, Embase, Emcare, and PsycINFO) from their inception until July 2024. The search strategy was derived from three topic areas: strabismus, quality of life, and children. A two-stage screening process involved screening titles and abstracts before full texts were retrieved and screened. Inclusion criteria required studies to have participants aged less than 18 years old with strabismus completing a measure of quality of life. Quality assessment was performed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist.

From 1,014 records, a total of 10 studies were included. Most studies reported children with strabismus had significantly reduced quality of life compared to children without strabismus, across all age groups. Three studies compared scores between different age groups. One indicated a greater reduction in quality of life in older children. Conversely, two found no significant difference between different age groups.

Findings indicated that strabismic children across all age groups experience reduced quality of life, although age-specific analysis was limited. A longitudinal study using an appropriate, validated outcome measure from diagnosis until adulthood may facilitate an age-specific analysis of quality of life.