1
|
Arblaster G, Buckley D, Barnes S, Davis H. Strabismus Surgery for Psychosocial Reasons-A Literature Review. Br Ir Orthopt J 2024; 20:107-132. [PMID: 38681188 PMCID: PMC11049605 DOI: 10.22599/bioj.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/04/2024] [Indexed: 05/01/2024] Open
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.
Collapse
Affiliation(s)
- Gemma Arblaster
- Division of Ophthalmology and Orthoptics, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, UK
- Orthoptic Department, Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - David Buckley
- Division of Ophthalmology and Orthoptics, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, UK
| | - Sarah Barnes
- School of Medicine and Population Health, University of Sheffield, UK
| | - Helen Davis
- Division of Ophthalmology and Orthoptics, School of Allied Health Professions, Nursing and Midwifery, University of Sheffield, UK
| |
Collapse
|
2
|
Translation and transcultural adaptation of the AS-20 scale to measure quality of life in adults with strabismus in Colombia, a pilot study. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023; 98:142-149. [PMID: 36577464 DOI: 10.1016/j.oftale.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 11/07/2022] [Indexed: 12/26/2022]
Abstract
BACKGROUND Strabismus generates a negative psychosocial impact on adult patients, affecting aspects such as self-perception and quality of life. There is no scale in Colombian Spanish that measures these impacts. OBJECTIVE To carry out the translation and cross-cultural adaptation of the AS-20 instrument into Colombian Spanish. MATERIALS AND METHODS Pilot test of a cross-sectional Study for the translation, reverse translation, and cross-cultural the AS-20 instrument from its original language, English, to Colombian Spanish, in adult patients with strabismus in Bogotá, Colombia. RESULTS 16 patients were assessed. The age range was between 18 and 68 years with a mean age of 41 years. The scale was answered in an average time of 10.62min. Difficulty was reported in three individuals for understanding two items (questions 8 and 14), which were resolved. CONCLUSION The translation and pilot test of AS-20 scale into Colombian Spanish was carried out, identifying and solving translational difficulties. Is the first step in the cross-cultural adaptation process. Based on the results, the validation and cross-cultural adaptation can be completed in a future study.
Collapse
|
3
|
Egocentric Distance Perception Disorder in Amblyopia. Psychol Belg 2021; 61:173-185. [PMID: 34221439 PMCID: PMC8231473 DOI: 10.5334/pb.1038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Egocentric distance perception is a psychological process in which observers use various depth cues to estimate the distance between a target and themselves. The impairment of basic visual function and treatment of amblyopia have been well documented. However, the disorder of egocentric distance perception of amblyopes is poorly understood. In this review, we describe the cognitive mechanism of egocentric distance perception, and then, we focus on empirical evidence for disorders in egocentric distance perception for amblyopes in the whole visual space. In the personal space (within 2 m), it is difficult for amblyopes to show normal hand-eye coordination; in the action space (within 2 m~30 m), amblyopes cannot accurately judge the distance of a target suspended in the air. Few studies have focused on the performance of amblyopes in the vista space (more than 30 m). Finally, five critical topics for future research are discussed: 1) it is necessary to systematically explore the mechanism of egocentric distance perception in all three spaces; 2) the laws of egocentric distance perception in moving objects for amblyopes should be explored; and 3) the comparison of three subtypes of amblyopia is still insufficient; 4) study the perception of distance under another theoretical framework; 5) explore the mechanisms of amblyopia by Virtual Reality.
Collapse
|
4
|
Kumaran SE, Khadka J, Baker R, Pesudovs K. Patient‐reported outcome measures in amblyopia and strabismus: a systematic review. Clin Exp Optom 2021. [DOI: 10.1111/cxo.12553] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Sheela E Kumaran
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
| | - Jyoti Khadka
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
| | - Rod Baker
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
| | - Konrad Pesudovs
- Discipline of Optometry and Vision Science, Flinders University, Adelaide, South Australia, Australia,
| |
Collapse
|
5
|
Paduca A, Arnaut O, Beschieru E, Lundmark PO, Bruenech JR. Shared decision making and patients satisfaction with strabismus care-a pilot study. BMC Med Inform Decis Mak 2021; 21:109. [PMID: 33771137 PMCID: PMC7995717 DOI: 10.1186/s12911-021-01469-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 03/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Strabismus is a complex disease that has various treatment approaches each with its own advantages and drawbacks. In this context, shared decisions making (SDM) is a communication process with the provider sharing all the relevant treatment alternatives, all the benefits, and risks of each procedure, while the patient shares all the preferences and values regarding his/her choices. In that way, SDM is a bidirectional process that goes beyond the typical informed consent. Therefore, it is known a little of the extent to which SDM influences the satisfaction with the treatment outcome along with strabismus patients. To study this correlation, an SDM-Q-9 questionnaire was provided within surgical consultations where treatment decisions were made; the SDM-Q-9 aims to assess the relationship between the post-operative patient's satisfaction and their SMD score. METHODS The study is considered a prospective observational pilot study. Eligible patients were adult patients diagnosed with strabismus, who had multiple treatment options, were given at the right of choice without being driven into a physician's preference. Ninety-three strabismus patients were asked to fill out the SDM-Q-9 questionnaire related to their perception of SDM during the entire period of strabismus treatment. After the treatment, patients were asked to rate their satisfaction level with the surgical outcome as excellent, good, fair, and poor. Descriptive statistics and the linear regression statistical tests (Spearman, Mann Whitney U, and Kriskal-Wallis) were used as analysis tools. RESULTS The average age of the participants was 24, where 50.6% were women. The mean SDM-Q-9 score among patients was 32 (IQR = 3). The postoperative patient satisfaction was rated as being excellent by 16 (17.2%) patients, good by 38 (40.9%), fair by 32 (34.4%), and poor by 7 patients (7.5%). Data analysis by linear regression statistical tests showed a positive correlation between the SDM-Q-9 score and the patient satisfaction related to the surgery outcome (B = 0.005, p < 0.001). Criteria in assessing patients' satisfaction were age, gender, and strabismus type. A positive correlation between SDM and real satisfaction (r = 0.834, p < 0.01) was found with age, and no significant relationship was found while taking into consideration the responder's gender and the strabismus type. CONCLUSIONS Assessing patient satisfaction after choosing a treatment for strabismus method helped us evaluate the gaps in constructive dialogue that would lead to a positive outcome for both patient and clinician. The correlation between the SDM process and the patients' satisfaction with surgery outcome, adjusted by age, has been established. These findings can serve as a springboard to further communicative improvements related to the SDM process and between patients and physicians, thereby consequently leading to patients' satisfaction raise in strabismus care. The study underlines the importance of further analysis and validation of on-ground interactions among the adolescent and adult patients and the clinicians across the strabismus management trajectory. A multicentral study and its validation will follow.
Collapse
Affiliation(s)
- Ala Paduca
- Faculty of Health and Social Science, South Eastern University Norway, Kongsberg, Norway. .,Ophthalmology Department, Universitatea de Stat de Medicina si Farmacie "Nicolae Testemitanu″, Chişinău, Republic of Moldova.
| | - Oleg Arnaut
- Department of Human Physiology and Biophysics, Universitatea de Stat de Medicina si Farmacie "Nicolae Testemitanu", Chişinău, Republic of Moldova
| | - Eugeniu Beschieru
- Department of Surgery No.1 "N. Anestiadi", Universitatea de Stat de Medicina si Farmacie "Nicolae Testemitanu", Chişinău, Republic of Moldova
| | - Per Olof Lundmark
- Faculty of Health and Social Science, South Eastern University Norway, Kongsberg, Norway
| | - Jan Richard Bruenech
- Faculty of Health and Social Science, South Eastern University Norway, Kongsberg, Norway
| |
Collapse
|
6
|
Zhao BW, Fu J, Wang JH, Bai HX, Liu PP, Guo YN, Zhang RH, Su H. Quality of life in adult intermittent exotropia and the risk factors. Int J Ophthalmol 2021; 14:442-447. [PMID: 33747823 DOI: 10.18240/ijo.2021.03.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 07/01/2020] [Indexed: 11/23/2022] Open
Abstract
AIM To study the quality of life of adult patients with intermittent exotropia (IXT) in China and analyze the factors affecting the quality of life in IXT patients. METHODS Totally 109 cases of normal eye (control group), 77 cases of IXT (IXT group) and 115 cases of strabismus control group (except IXT) were collected. The quality of life of the patients was assessed by Chinese version of adult strabismus patient's quality of life scale (CAS-20). The differences of general characteristics, visual function and quality of life were analyzed, and the effects of individual factors and visual function on quality of life of patients with IXT were analyzed. RESULTS The IXT group had a high proportion of patients with family history, low proportion of patients with amblyopia compared with strabismus control group. The proportion with normal near and far stereopsis of IXT group were lower than that of normal control group. The best corrected visual acuity of IXT group was higher than that of strabismus control group, but lower than the control group. In addition, the median strabismus degree in IXT group was higher than that in other strabismus control group. The median psychosocial scores and median visual function scores of the IXT group was lower than that of the normal control group, but not different from strabismus control group. Occupation status, course of disease, far stereopsis and near stereopsis significantly affected the quality of life in IXT patients. CONCLUSION Adult IXT patients in China have a certain proportion of family history and lower quality of life, The main factors affecting the quality of life of IXT patients is stereopsis, course of disease and occupation status.
Collapse
Affiliation(s)
- Bo-Wen Zhao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing 100730, China
| | - Jing Fu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing 100730, China
| | - Jing-Hui Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing 100730, China
| | - Hai-Xia Bai
- Eye Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, Zhejiang Province, China
| | - Pei-Pei Liu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing 100730, China
| | - Ya-Nan Guo
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing 100730, China
| | - Rong-Han Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing 100730, China
| | - Han Su
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing 100730, China
| |
Collapse
|
7
|
Differences in quality-of-life dimensions of Adult Strabismus Quality of Life and Amblyopia & Strabismus Questionnaires. Graefes Arch Clin Exp Ophthalmol 2017; 255:1851-1858. [PMID: 28555418 PMCID: PMC5554281 DOI: 10.1007/s00417-017-3694-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 05/03/2017] [Accepted: 05/08/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose The Adult Strabismus Quality of Life Questionnaire (AS-20) and the Amblyopia & Strabismus Questionnaire (A&SQ) both measure health-related quality of life in strabismus patients. We evaluated to what extent these instruments cover similar domains by identifying the underlying quality-of-life factors of the combined questionnaires. Methods Participants were adults from a historic cohort with available orthoptic childhood data documenting strabismus and/or amblyopia. They had previously completed the A&SQ and were now asked to complete the AS-20. Factor analysis was performed on the correlation-matrix of the combined AS-20 and A&SQ data to identify common underlying factors. The identified factors were correlated with the clinical variables of angle of strabismus, degree of binocular vision, and visual acuity of the worse eye. Results One hundred ten patients completed both questionnaires (mean age, 44 years; range, 38–51 years). Six factors were found that together explained 78% of the total variance. The factor structure was dominated by the first four factors. One factor contained psychosocial and social-contact items, and another factor depth-perception items from both questionnaires. A third factor contained seven items—only from the AS-20—on eye strain, stress, and difficulties with reading and with concentrating. A fourth factor contained seven items—only from the A&SQ—on fear of losing the better eye and visual disorientation, specific for amblyopia. Current visual acuity of the worse eye correlated with depth-perception items and vision-related items, whereas current binocular vision correlated with psychosocial and social-contact items, in 93 patients. Conclusions Factor analysis suggests that the AS-20 and A&SQ measure a similar psychosocial quality-of-life domain. However, functional problems like avoidance of reading, difficulty in concentrating, eye stress, reading problems, inability to enjoy hobbies, and need for frequent breaks when reading are represented only in the AS-20. During the development of the A&SQ, asthenopia items were considered insufficiently specific for strabismus and were excluded a priori. The patients who generated the items for the AS-20 had, in majority, adulthood-onset strabismus and diplopia and were, hence, more likely to develop such complaints than our adult patients with childhood-onset strabismus and/or amblyopia.
Collapse
|
8
|
Wang Z, Zhou J, Luo X, Xu Y, She X, Chen L, Yin H, Wang X. Rasch Analysis of the Adult Strabismus Quality of Life Questionnaire (AS-20) among Chinese Adult Patients with Strabismus. PLoS One 2015; 10:e0142188. [PMID: 26544048 PMCID: PMC4636299 DOI: 10.1371/journal.pone.0142188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 10/19/2015] [Indexed: 12/03/2022] Open
Abstract
Background The impact of strabismus on visual function, self-image, self-esteem, and social interactions decrease health-related quality of life (HRQoL).The purpose of this study was to evaluate and refine the adult strabismus quality of life questionnaire (AS-20) by using Rasch analysis among Chinese adult patients with strabismus. Methods We evaluated the fitness of the AS-20 with Rasch model in Chinese population by assessing unidimensionality, infit and outfit, person and item separation index and reliability, response ordering, targeting and differential item functioning (DIF). Results The overall AS-20 did not demonstrate unidimensional; however, it was achieved separately in the two Rasch-revised subscales: the psychosocial subscale (11 items) and the function subscale (9 items). The features of good targeting, optimal item infit and outfit, and no notable local dependence were found for each of the subscales. The rating scale was appropriate for the psychosocial subscale but a reduction to four response categories was required for the function subscale. No significant DIF were revealed for any demographic and clinical factors (e.g., age, gender, and strabismus types). Conclusion The AS-20 was demonstrated by Rasch analysis to be a rigorous instrument for measuring health-related quality of life in Chinese strabismus patents if some revisions were made regarding the subscale construct and response options.
Collapse
Affiliation(s)
- Zonghua Wang
- School of Nursing, Third Military Medical University, Chongqing, China
| | - Juan Zhou
- School of Nursing, Third Military Medical University, Chongqing, China
| | - Xingli Luo
- Department of Ophthalmology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yan Xu
- Department of Ophthalmology, Southwest Eye Hospital, Third Military Medical University, Chongqing, China
| | - Xi She
- Department of Ophthalmology, Xinqiao Hospital, Third Military Medical University, Chongqing, China
| | - Ling Chen
- Department of Gastroenterology, the 324th Hospital of PLA, Chongqing, China
| | - Honghua Yin
- Department of Ophthalmology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Xianyuan Wang
- School of Nursing, Third Military Medical University, Chongqing, China
- * E-mail:
| |
Collapse
|
9
|
Gothwal VK, Bharani S, Kekunnaya R, Chhablani P, Sachdeva V, Pehere NK, Narasaiah A, Gunturu R. Measuring Health-Related Quality of Life in Strabismus: A Modification of the Adult Strabismus-20 (AS-20) Questionnaire Using Rasch Analysis. PLoS One 2015; 10:e0127064. [PMID: 26011430 PMCID: PMC4444101 DOI: 10.1371/journal.pone.0127064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/10/2015] [Indexed: 11/18/2022] Open
Abstract
Purpose To evaluate the psychometric properties of the Adult Strabismus-20 (AS-20)- a health-related quality of life (HRQoL) questionnaire in adults with strabismus, and if flawed, to revise the AS-20 and its subscales creating valid measurement scales. Methods 584 adults (meanage, 27.5 years) with strabismus were recruited from an outpatient clinic at a South Indian tertiary eye care centre and were administered the AS-20 questionnaire.The AS-20 was translated and back translated into two Indian languages. The AS-20 and its two 10-item subscales – ‘psychosocial’ and ‘function’were assessed separately for fit to the Rasch model, including an assessment of the rating scale, unidimensionality (by principal components analysis), measurement precision by person separation reliability, PSR, targeting, and differential item functioning (DIF; notable > 1.0 logits). Results Response categories were not used as intended, thereby, required re-organization and reducing their number from 5 to 3. The AS-20 had adequate measurement precision (PSR = 0.87) but lacked unidimensionality; however, deletion of the six multi-dimensionality causing items and an additional three misfitting items resulted in 11-item unidimensional questionnaire (AS-11). Two items failed to satisfy the model expectations in the ‘psychosocial’ subscale and were deleted – resulting in an 8-item unidimensional scale with adequate PSR (0.81) and targeting (0.23 logits). One item misfit in the ‘function’ subscale and was deleted—resulting in a 9 item Rasch-revised unidimensional subscale with acceptable PSR (0.80) and targeting (0.97 logits).None of the items displayed notable DIF by age, gender and level of education. Conclusions The AS-11 and its two Rasch-revised subscales – 8-item psychosocial and 9-item function subscale may be more appropriate than the original AS-20 and its two 10-item subscales for use as unidimensional measures of HRQoL in adults with strabismus in India. Further work is required to establish the validity of the revised rating scale.
Collapse
Affiliation(s)
- Vijaya K. Gothwal
- Meera and L B Deshpande Centre for Sight Enhancement, L V Prasad Eye Institute, KallamAnji Reddy campus, Hyderabad, India
- * E-mail:
| | - Seelam Bharani
- Meera and L B Deshpande Centre for Sight Enhancement, L V Prasad Eye Institute, KallamAnji Reddy campus, Hyderabad, India
| | - Ramesh Kekunnaya
- Jasti V Ramanamma Children’s Eye Care Centre, L V Prasad Eye Institute, Hyderabad, India
| | - PreetiPatil Chhablani
- Jasti V Ramanamma Children’s Eye Care Centre, L V Prasad Eye Institute, Hyderabad, India
| | - Virender Sachdeva
- Nimmagadda Prasad Children’s Eye Care Centre, L V Prasad Eye Institute, GMR Varalakshmi Campus, Vishakapatnam, India
| | - Niranjan K. Pehere
- The David Brown Children’s Eye Care Centre, KodeVenkatadriChowdary Campus, Vijayawada, India
| | - Asa Narasaiah
- The David Brown Children’s Eye Care Centre, KodeVenkatadriChowdary Campus, Vijayawada, India
| | - Rekha Gunturu
- Nimmagadda Prasad Children’s Eye Care Centre, L V Prasad Eye Institute, GMR Varalakshmi Campus, Vishakapatnam, India
| |
Collapse
|