Strabismus Surgery for Psychosocial Reasons-A Literature Review

Gemma Arblaster; David Buckley; Sarah Barnes; Helen Davis

doi:10.22599/bioj.352

Strabismus Surgery for Psychosocial Reasons-A Literature Review

Br Ir Orthopt J. 2024 Apr 22;20(1):107-132. doi: 10.22599/bioj.352. eCollection 2024.

Authors

Gemma Arblaster^{1

2}, David Buckley¹, Sarah Barnes³, Helen Davis¹

Affiliations

¹ Division of Ophthalmology and Orthoptics, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, UK.
² Orthoptic Department, Sheffield Teaching Hospitals NHS Foundation Trust, UK.
³ School of Medicine and Population Health, University of Sheffield, UK.

Abstract

Introduction: Strabismus surgery may be undertaken for visual benefit, to improve or eliminate diplopia symptoms, or to restore or improve binocular single vision (BSV). In patients without visual symptoms or expected visual benefit, strabismus surgery may still be undertaken if the presence of strabismus causes the patient psychosocial symptoms. To evaluate strabismus surgery undertaken for psychosocial reasons, evidence of postoperative outcomes in this specific cohort is needed.

Methods: A systematic search of the literature was conducted (1946-2023) to identify evidence where postoperative outcomes were reported for adult patients (age 18 years and above) who had undergone strabismus surgery for psychosocial reasons.

Results: Sixty-nine papers were included in the literature review. Most sources of evidence included patients within heterogeneous cohorts of strabismus surgery outcomes, with a range of symptoms and differing surgical aims.

Discussion: In adults who underwent strabismus surgery for psychosocial reasons, improved postoperative ocular alignment and/or improved health related quality of life (HRQoL) were common. Strabismus surgery outcomes appeared to be measured satisfactorily at three months postoperatively. Additional surgical outcomes, including an expanded field of vision, unexpected BSV, improved binocular summation, improved task performance and improved eye movements have been reported, but not fully investigated. There was a lack of consensus on how postoperative success should be defined and measured. A core outcome set for strabismus has been suggested and there is potential to add to the available evidence by investigating which outcome measures are most relevant to those with strabismus and psychosocial symptoms. There is a growing need for robust evidence in this specific subgroup of patients due to a lack of evidence specifically reporting postoperative outcomes in adults with strabismus and psychosocial symptoms.

Keywords: health related quality of life; outcomes; psychosocial; quality of life; strabismus; strabismus surgery.

Publication types

Review

Grants and funding

Gemma Arblaster was funded by an NIHR Clinical Doctoral Research Fellowship (ICA-CDRF-2016-02-063). The views expressed are those of the authors and not necessarily those of NIHR or the Department of Health and Social Care.