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Clinical science
Improvement in psychiatric symptoms after strabismus surgery in adolescent patients in long-term follow-up
  1. Serdar Ozates1,
  2. Melike Ezerbolat Ozates2,
  3. Cigdem Ulku Can3,
  4. Sibel Polat3,
  5. Hakan Halit Yasar3,
  6. Busra Taskale3,
  7. Ali Kemal Gogus2
  1. 1 Department of Ophthalmology, Dr. Sami Ulus Maternity, Children’s Health and Diseases Training and Research Hospital, Ankara, Turkey
  2. 2 Department of Psychiatry, Ankara University Medical Faculty, Ankara, Turkey
  3. 3 Department of Ophthalmology, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
  1. Correspondence to Dr Serdar Ozates, Department of Ophthalmology, Dr. Sami Ulus Maternity, Children’s Health and Diseases Training and Research Hospital, Ankara 06080, Turkey; serdarozates{at}gmail.com

Abstract

Aims To assess the psychological effects of preoperative primary eye position and surgical correction of strabismus in adolescent patients.

Methods Eighty-three adolescent patients with exotropia were included in this observational and prospective study. Patients with preoperative manifest exotropia formed the manifest exotropia group. Patients with intermittent exotropia that had orthophoria with overcorrecting minus lenses and recently increased frequency of manifest phase were indicated for surgery and formed the latent deviation group. All patients were scored with the Turkish version of the Social Appearance Anxiety Scale (SAAS), depression subscale of Hospital Anxiety and Depression Scale (HAD-D) Brief Fear of Negative Evaluation Scale (BFNE), state anxiety subscale of State-Trait Anxiety Inventory (STAI-S) and trait anxiety subscale of State-Trait Anxiety Inventory (STAI-T) before and 1 year after strabismus surgery.

Results The mean preoperative scores of the HAD-D, SAAS, BFNE, STAI-S and STAI-T before strabismus surgery were significantly higher in the manifest exotropia group than in the latent deviation group (p≤0.001 for all). Surgical correction significantly improved the outcomes of all scales in the manifest exotropia group (p≤0.001 for all). Outcomes of the STAI-S and STAI-T significantly improved in the latent deviation group after the surgery (p=0.008, p=0.006, respectively), whereas outcomes of the HAD-D, SAAS and BFNE did not improve (p=0.079, p=0.071, p=0.127, respectively). The mean postoperative scores of all scales did not differ between the two groups (p>0.05 for all).

Conclusions Strabismus has psychological consequences in adolescent patients, and the visible eye deviation caused by strabismus is a strong indicator of psychological distress.

  • strabismus
  • exotropia
  • strabismus surgery
  • depression
  • anxiety

https://doi.org/10.1136/bjophthalmol-2018-312510

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    Footnotes

    • Contributors SO designed the study, analysed the data and drafted and revised the paper. MEO designed the data collection tools, monitored data collection and revised the draft paper. CUC designed the study and drafted the paper. SP revised the draft paper. HHY monitored data collection and wrote statistical analysis plan. BT monitored the data collection. AKG designed the data collection tools and wrote statistical analysis plan.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval The study protocol was approved by the Institutional Board of the Ankara Numune Training and Research Hospital ethics committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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