The effect of strabismus surgery on self-concept and peer relationship in chıldren

To evaluate the impact of strabismus and strabismus surgery on self-concept and peer relationship in children.

Twenty-one patients with constant strabismus and 25 age- and sex- matched healthy controls were prospectively evaluated. Self-concept and peer relationship were assessed using the Piers-Harris Children's Self-Concept Scale (PHS) and the Peer Relationship Scale (PRS) before and 6 months after surgery. All patients underwent psychiatric evaluation and completed the psychometric assessments administered by a child and adolescent psychiatrist. The same scales were administered once to the control group.

Significant postoperative improvements were detected in total PHS and total PRS scores, as well as in Physical Appearance and Attributes (PHY) and Popularity (POP) subdimensions of the PHS and the Self-Disclosure subdimension of the PRS (for all, P ≤ 0.001). Compared with the strabismus group, healthy controls showed higher total PRS scores and all PRS subdimensions both before and after surgery (for all, P ≤ 0.001). In contrast, no difference was observed in total PHS scores between groups after surgery (P = 0.822). Moreover, postoperative PHY and POP scores in the strabismus patients were significantly higher than those of the control group (for both, P < 0.001).

Strabismus negatively affects self-concept and peer relationships in children. Surgical correction leads to meaningful psychosocial improvement. A comprehensive strategy for children with strabismus may be warranted, including psychological screening, early identification of mental health problems, support for social integration, and increased awareness to prevent psychosocial issues from being overlooked.