Strabismus and Self-Perception: A Study on Self-Concept in Pediatric Strabismus Patients and the Impact of Surgical...

Introduction: This study aimed to investigate the impact of strabismus on self-concept in school-aged children and to evaluate changes in self-concept six months after strabismus surgery. Subjects and Methods: This prospective multicenter study included children aged 7-15 years who underwent strabismus surgery at the Strabismus Units of Beyoğlu Eye Research and Training Hospital and Marmara University Hospital between December 2023 and June 2024. Self-concept was assessed using the validated Turkish version of the Piers-Harris Self-Concept Scale (PHSCS) before surgery and six months postoperatively. Only patients with complete preoperative and postoperative assessments were included in the final paired analysis. Results: A total of 116 children were enrolled, of whom 84 (42 boys and 42 girls; mean age, 10.9 ± 2.2 years) had complete data and were included in the final analysis. Overall, 73.6% of participants reported that strabismus affected their daily lives, with 77.4% describing this impact as negative. Furthermore, 65.5% stated that strabismus affected their relationships with friends. Following surgery, 80.9% of participants were satisfied with the surgical outcome, and 85.7% would recommend the procedure to others. The mean total PHSCS score increased from 58.2 ± 10.4 preoperatively to 59.0 ± 10.1 postoperatively, although this difference did not reach statistical significance (p = 0.05). In contrast, the Physical Appearance and Attributes subscale showed a significant improvement after surgery (8.3 ± 1.6 vs. 8.9 ± 1.9, p < 0.005), whereas no significant changes were observed in the remaining subscales. Conclusions: School-aged children with strabismus may experience psychosocial challenges related to their condition, particularly in their interactions with peers. Although overall self-concept remained largely unchanged, self-perception of physical appearance improved following strabismus surgery. These findings suggest that surgical correction may contribute to improvements in selected aspects of self-concept; however, larger prospective controlled studies are needed to confirm these observations.