Abstract
Purpose :
Strabismus surgery in patients without diplopia or demonstrable potential binocular single vision is typically undertaken for psychosocial reasons. However, this type of strabismus surgery has been reported to lead to changes in vision or improvements in performing tasks and daily activities in some cases. This study aimed to explore patient experiences of changes in vision and task performance following strabismus surgery for psychosocial benefit.
Methods :
A qualitative study using semi-structured interviews was conducted with 13 adults who had undergone strabismus surgery for planned psychosocial benefit 4.5-20 months earlier. Maximum variation sampling was used to recruit patients, the dimensions were sex (male (n=6) / female (n=7)) and age group (younger 18-35 (n=6) / older 36+ (n=7)). Patients were asked what they felt had changed (improved or worsened) or not changed following strabismus surgery. Interviews were recorded, transcribed verbatim and analysed using nVivo software and a coding framework.
Results :
All patients had strabismus surgery for psychosocial reasons, none had diplopia or demonstrable binocular vision pre or post-operatively. Four themes emerged from the analysis of the interviews: improvements in vision; task performance; physical symptoms and confidence. Perceived visual improvements included peripheral vision, focussing, using the eyes together or the strabismic eye more and eye movements. Perceived task performance improvements included driving, using screen devices, work ability, balance, reading and other near activities. Patients described improvements in physical symptoms including less ocular pain or discomfort, less eye strain or tightness, fewer headaches and less ocular tiredness or need to take rest breaks. Patients also described improved self-confidence, self-perception, confidence in abilities and vision.
Conclusions :
Despite strabismus surgery being undertaken to improve psychosocial symptoms, most adult patients felt their vision, task performance or physical symptoms improved following surgery. These are in addition to the improvements in confidence and self-perception typically expected in this group. Whilst not reported by every patient, greater improvements are perceived by patients post-operatively than are currently measured clinically. Quantitative studies are underway to explore these perceived postoperative changes and inform future outcome measures.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.