Association of strabismus with functional impairment in children in the USA
Reviewed by Fiona Rowe

In this study the authors aimed to (1) determine if strabismus is associated with clinically significant functional impairment, (2) identify specific domains of impairment and (3) examine predictors of impairment among children aged 5-17 years. Data were extracted and analysed from the 1996-2015 medical expenditure panel survey in the USA (MEPS) which included 132,819 children aged 5-17 years. Diagnosis of strabismus was in 201 of these children; 49.2% male, 72.4% aged 5-11 and 27.6% aged 12-17 years. 45.5% were white, 4.2% black, 24.3% poor-low income and 43.8% high income. Diagnosis of strabismus was more likely in the younger age group, in those with higher income, those with private health insurance and having ≥ one chronic comorbid disease. Strabismus diagnosis was associated with greater overall functional limitation with nearly two-fold greater odds. Specific domains affected included getting along with mother / father / other children, nervousness, getting involved in sports / hobbies, behaviour at home, and staying out of trouble. The authors conclude childhood strabismus is a burdensome condition that limits full engagement in relationships and activities with greater impairment in older male children in the Midwest US with public insurance cover. They recommend consideration of functional impairment in management discussions.

Association of pediatric strabismus and functional impairment: a cross-sectional nationwide analysis.
Cheng BT, Kim AB, Nadimpalli S, et al.
JOURNAL OF PEDIATRIC OPHTHALMOLOGY AND STRABISMUS
2023;60(3):268-76.