To assess knowledge and attitude of parents toward children suffering from strabismus in Indian subcontinent

Community Knowledge, Attitude, and Practices Related to Strabismus and Strabismus Treatment and Surgery in Al-Jouf Region, Saudi Arabia

BACKGROUND

Strabismus is the misalignment of the visual axis of both eyes caused by abnormalities in binocular vision or anomalies of neuromuscular control of ocular motility. This study aimed to assess the community knowledge, attitude, and practices related to strabismus and strabismus treatment and surgery in the Al-Jouf region of Saudi Arabia.

METHODS

This study utilized a quantitative cross-sectional design. The consented volunteering adult participants were randomly selected through sequential enrollment to the completion of the target sample size from five population groups constituting the Al-Jouf region of Saudi Arabia. The data were collected through an online validated self-administered questionnaire. The collected data were analyzed using descriptive and inferential statistics.

RESULTS

The study included 340 participants; 67.6% of them were females and 32.4% were males. Only 66.8% of participants correctly defined strabismus. Symptoms of strabismus were identified as double vision (58.5%), blurred vision (48.2%), headache (31.8%), eye fatigue (41.5%), and difficulty reading (47.1%). Regarding risk factors of strabismus, 48.5% reported family history, 39.4% reported uncorrected refractive errors, and 23.2% reported long screen time. Complications of untreated strabismus were reported as low self-confidence (39.1%), vision loss (27.6%), poor interpersonal relationships (25.9%), amblyopia (42.6%), and cosmetic stigma (14.1%). Only 45.6% of the participants agreed to marry someone with strabismus or allow their relatives to do so. The majority of participants (72.6%) would advise a strabismus patient to visit an ophthalmologist. Despite a higher knowledge regarding strabismus among females, younger agers, higher education, single persons, workers/students, and those inhabiting the capital city of the region, such association did not reach significance.

CONCLUSION

The study shows a moderate level of knowledge, attitude, and practices among the general population of Al-Jouf Saudis toward strabismus. There was no significant relationship between knowledge of strabismus and any of the demographic characteristics of the participants. This might prove detrimental to the early detection and treatment of strabismus to prevent its complications and improve its outcomes and the quality of patients' lives. Institution of correlation plans are mandated by the Ministry of Health and interested stakeholders.

Assessment of parental awareness about pediatric visual problems by Knowledge-Attitude-Practice survey in South India

Purpose

To find out parents' knowledge, attitude, and treatment practice (KAP) toward pediatric eye problems and to assess the effect of demographic factors such as gender, age, educational status, and number of children on KAP.

Methods

A cross-sectional descriptive study was conducted in a hospital setting. Two hundred parents were randomly selected for the questionnaire. All parents had children who were included in Systematic Pediatric Eye Care Through Sibling Screening Strategies (SPECSSS) study. A survey with 15 questions on KAP of pediatric eye diseases was prepared and administered to parents coming to a tertiary eye hospital with varied experience and education qualifications.

Results

The mean age of 200 patients was 9.6 (3.4) years, with the majority of them male (n = 110; 55.0%). The majority of the children (n = 91, 45.5%) were between the age group of 6-10 years. Knowledge of visual problems among parents was of a good grade in 9% only. The attitude of the parents toward the visual problem was positive at 17%, and the responses regarding the practice were of excellent grade at 46.5% and good at 26.5%. Analysis suggests that the level of knowledge and practice were not significantly associated with the demographic factors (p > 0.05). The positive attitude toward the visual problems of the children was associated with education of the parents (p < 0.05) and the father occupation (p < 0.05).

Conclusion

Knowledge about pediatric eye diseases was poor among parents and it was significantly affected by education and occupation of parents. The parents have positive attitude toward enhancing their attitude in treatment.

Psychological and Social Challenges Parents of Children With Strabismus Face in Qassim Region, Saudi Arabia: A Cross-Sectional Study

Aim Strabismus or squint is when one eye is misaligned or looking in a different direction. Some people consider strabismus as a cosmetic problem, causing patients in this condition to be mishandled, especially children, which might affect their vision and their quality of life. This study aimed to evaluate the psychological and social challenges faced by parents of children with strabismus during the years 2020-2021. Subjects and methods This is a cross-sectional study conducted among parents who have children with strabismus onset from birth till the age of 16 years. A self-administered questionnaire was distributed among parents during their visits to the vision eye specialist center. The questionnaire included socio-demographic characteristics of patients with strabismus and a 12-item questionnaire to measure the psychological impact on the parents of children with strabismus. Results Out of the 105 respondents, 65.7% were fathers, and 55.2% had children aged six years old or less. The most prominent strabismus type was esotropia (where the eye turns inward; 38.1%), while the most common nature of strabismus was intermittent (76.2%). The mean total score of psychological impact was 36.2 (SD=8.15) out of 60 points, with 62.9% considered as having an average psychological impact. Moreover, 77.1% of the respondents believed that strabismus could be treated and improved. Conclusion There was a moderate psychosocial challenge among parents of children with strabismus. Out of all the subjects, mothers who had prior visits to government hospitals were noticed to be greatly affected psychologically as compared to other subjects.

Knowledge and attitude towards strabismus among adult residents in Woreta town, North West Ethiopia: A community-based study

BACKGROUND

Strabismus is a visual disorder where the eyes are misaligned and point in different directions. Untreated strabismus can lead to amblyopia, loss of binocular vision, and social stigma due to its appearance. Since it is assumed that knowledge is pertinent for early screening and prevention of strabismus, the main objective of this study was to assess knowledge and attitudes toward strabismus in Woreta town, Northwest Ethiopia. Providing data in this area is important for planning health policies.

METHODS

A community-based cross-sectional study was done in Woreta town from April-May 2020 with a sample size of 424. A systematic random sampling technique was employed to achieve the required sample size. A pre-tested self-administered questionnaire was used to collect the data. Data were entered using epi-data version 3.1, then processed and analyzed via SPSS version 20. Descriptive and analytical statistics were employed to summarize the data. A p-value of less than 0.05 was used to declare statistical significance.

RESULT

A total of 401 individuals aged over 18 years participated, with a response rate of 94.5%. Of those who responded, 56.6% were males. Of all the participants, 36.9% were illiterate. The proportion of people with poor knowledge of strabismus was 45.1%. It was shown that 53.9% of the respondents had a favorable attitude. Older age, higher educational level, having a history of eye examination, and a having a family history of strabismus were significantly associated with good knowledge of strabismus. A higher educational level, older age, and hearing about strabismus were significantly associated with a favorable attitude toward strabismus.

CONCLUSION AND RECOMMENDATION

The proportion of good knowledge and favorable attitude towards strabismus were lower than previously reported in Gondar City, Northwest Ethiopia. There is a need to provide health education and promotion campaigns on strabismus to the community: what strabismus is, its' possible treatments and the need to bring children to the eye care center for early diagnosis and treatment.

Knowledge, Attitude, and Practice Among Parents of Strabismic Children in Saudi Arabia: A Cross-Sectional Study

Background Strabismus is a reversible condition that must be identified and treated during the critical period of childhood. Thus, this study aims to evaluate the degree of knowledge, attitude, and practice among parents of strabismic children in Riyadh, Saudi Arabia. Method To this end, a cross-sectional study was conducted from August 2021 to November 2021 with a sample size of 424 parents of children with strabismus seeking ophthalmologic consultants in private and governmental ophthalmology clinics in Riyadh, Saudi Arabia. A self-administered questionnaire was used to collect the data. The questionnaire contains knowledge-related questions about strabismus, beliefs-related questions, questions addressing the barriers parents face regarding strabismus in a child, and sources of information about cross-eye and its management. Data were analysed using the SPSS database version 21 (IBM Corp., Armonk, NY, USA). P-values <0.5 was used for clinical significance. Result We found that most parents know there is a relationship between strabismus and refractive errors (69%) and cross eye can be corrected (55%). Moreover, strabismus causes psychosocial difficulties (55%), low self-esteem, and low school performance. Parents of strabismic children believed that their love for their children is not affected due to crossed eyes (53%) and that strabismic children should not be taken to traditional healers (59%). Barriers faced during the management of strabismus are parents' negligence (76%), fear of surgery (34%), and high cost (29%). Doctors are the most used and preferred source of information among parents of strabismic children. Conclusion This study identifies gaps in knowledge, wrong beliefs in society, and the barriers faced by parents of strabismic children. Thus, raising awareness of the importance of detecting and treating strabismus early, avoiding psychosocial complications, and improving children's quality of life.

Parents’ Awareness and Perception of Children’s Eye Diseases in Madinah, Saudi Arabia: A Cross-Sectional Study

Background

The visual system becomes more susceptible to conditions causing abnormal binocular interaction or blurred visual input as it matures during the first six years of life. Therefore, detection and treatment of visual impairment at a young age can lower the burden of the condition in adulthood. According to estimates, there are 19 million children worldwide with visual impairment, and 1.4 million children suffer from blindness. One of the strategies to address blinding eye conditions and visual impairment is through health promotion. For children, the efficient way of intervention is through parents and their school environment. Therefore, the establishment of an effective health promotion model for addressing childhood blindness requires awareness building of parents and health care practices. Few studies were undertaken in Saudi Arabia to focus on the awareness of parents about childhood eye diseases and visual impairment. The aim of this study is to assess parents’ awareness and perception of children’s eye diseases in Madinah, Saudi Arabia.

Methods

This cross-sectional study was conducted in Madinah, Saudi Arabia, from January to December 2021. A self-administered questionnaire was randomly distributed to parents of children aged 15 and younger via WhatsApp. The survey consisted of four main sections: socio-demographic data, knowledge about eye care, knowledge about eye diseases, and eye care practice.

Results

The knowledge about eye diseases in children was of excellent grade in 20 parents (3.6%), good in 101 (18.2%), and poor in 434 (78.2%). Knowledge was good in 287 parents (51.7%) for amblyopia, 65 (11.7%) for childhood cataract, and 69 (12.4%) for childhood glaucoma. The attitude regarding children wearing spectacles and undergoing ophthalmic surgery when needed was positive in 427 (76.9%) and 474 (85.4%) parents, respectively. Over half of the participants (58.6%) had visited an ophthalmology clinic for the examination of their children. Doctors, campaigns, and social media were the preferred modes of receiving knowledge. Participants aged 51 years or over (p = 0.022), with a higher income level (p = 0.004), of Saudi origin (p = 0.036), and those with a child with an eye disease (p = 0.001) had significantly higher knowledge scores about childhood eye diseases.

Conclusion

The levels of knowledge, practice, and attitude among parents regarding pediatric eye diseases were unsatisfactory. Health promotion through utilizing parents’ preferred modes of media could improve the eye care of children in the study area. 

Attitude and related factors towards strabismus among adults living in Gondar town, Northwest Ethiopia: a community-based cross-sectional study

Cultural belief in Ethiopia showed that strabismus can be caused by exposure to sunlight during infancy, an outrage from God, and looking sideways. In addition, Ethiopians also believe that strabismus can resolve by its self and is a sign of good luck. Due to these reasons many patients with strabismus come to eye care clinics after developing amblyopia. This study aimed to assess the level of attitude and related factors toward strabismus among adults living in Gondar town, Northwest Ethiopia. A community-based cross-sectional study was conducted on a sample size of 634 adults from April 9 to April 23, 2019. Data were collected using a pretested structured questionnaire through face-to-face interviews, and the study participants were chosen by applying a multistage random sampling technique. Data were entered with EPI info version 7 and imported into SPSS version 20 for analysis. Frequency, statistical summary, and cross-tabulations were used for the descriptive analysis of the entered data. Binary logistic regression was fitted, and all independent variables with a P-value of less than 0.2 in the bivariable analysis were entered into a multivariable binary logistic regression. Variables with a P-value of less than or equal to 0.05 were considered statistically significant. Respondents who answered greater than or equal to the median score of attitude-related questions were designated to have a favorable attitude toward strabismus. In this study, 602 adults were participated with a response rate of 94.9% and the median age of the participants was 33 ± 14 years. The overall proportion of favorable attitudes toward strabismus was 71.8%. Having secondary school as an educational status (AOR = 2.8 (95% CI: 1.2, 6.4)) and heard about strabismus (AOR = 7.4 (95%CI: 3.7, 14.9)) were positively whereas being unemployed (AOR = 0.3(95% CI: 0.1, 0.7)) and high monthly income (AOR = 0.5(95%CI: 0.3, 0.9)) were negatively associated with a favorable attitude regarding strabismus. Eighty-five percent (88.5%) of participants agreed that early treatment of strabismus had a better outcome. Besides, 57.6% of participants have agreed that untreated strabismus can cause amblyopia. About three fourth of the study participants had a favorable attitude toward strabismus. Educational status, heard about strabismus, occupation, and monthly income were significantly associated with a favorable attitude toward strabismus. Most of the study participants agreed that untreated strabismus can cause poor cosmoses. Fear of surgery and high cost were reported by study participants as the main barriers to seeking treatment of strabismus.

Amblyopia and Routine Eye Exam in Children: Parent's Perspective

Amblyopia is a reduced best-corrected visual acuity of one or both eyes that cannot be attributed to a structural abnormality; it is a functional reduction in the vision of an eye caused by disuse during a critical period of visual development. It is considered the leading cause of visual defects in children. With early diagnosis and treatment, children with amblyopia can significantly improve their vision. However, if it is neglected and not treated during childhood, unfortunately, it permanently decreases vision. Therefore, prevention, detection, and treatment largely depend on parents. This article explores parents' perspectives on amblyopia and routine examination of their children's eyes. A cross-sectional study used an electronic questionnaire consisting of five main sections to assess the level of awareness of amblyopia among parents. As a result, a total of 325 participants were included in our analysis. 209 (64.3%) were mothers, and 116 (35/7%) were fathers. The age groups were 35-50 years of age (61.5%), 20-34 years (23.4%), and older than 50 years (15%). Participants with a history of amblyopia numbered 23 (7.1%), and 39 had an amblyopic child (12%). A good awareness level of amblyopia among parents was found in only 10 (3%) participants, a fair awareness level in 202 (62%), and 113 (35%) participants were classified as having a poor awareness level of amblyopia. Only 13.8% of the parents took their children for yearly routine eye exams, while the majority (72%) took their children only if they had a complaint, and 14.2% took them for eye checkups only before school entry. In conclusion, parents' awareness of amblyopia in Tabuk City, KSA, was low. In addition, a limited proportion of parents reported consistently taking their children for routine eye exams. Therefore, raising awareness should be considered in public education regarding the disease.

The impact of strabismus on psychosocial heath and quality of life: a systematic review

Strabismus can hinder an individual's ability to perform daily functions and negatively affect their well-being. I examine the impact strabismus has on psychosocial health and quality of life in children and adults and evaluate the challenges confronted by parents of children with strabismus. Numerous misconceptions exist regarding the impact strabismus has on overall health. Negative attitudes persist toward those affected, resulting in difficulties with self-image. Individuals with strabismus are at increased risk for both visual system and psychiatric disorders. Misinformation regarding available treatment options for children and adults with strabismus continues to exist, resulting in decreased access to care. Improved education of health care providers can increase appropriate referrals and initiation of treatment. Treatment of strabismus is not merely cosmetic and has the potential to improve psychosocial health and quality of life for children and adults with and without diplopia.

Knowledge towards Strabismus and Associated Factors among Adults in Gondar Town, Northwest Ethiopia

Introduction. Strabismus/squint is an ocular misalignment in which the eyes are not properly aligned with each other. It is an avoidable cause of blindness and has a global prevalence which ranges from 2% to 6%. Knowledge of eye diseases is important in encouraging people to seek early treatment, which further helps in reducing the burden of visual impairment. Studies in Ethiopia showed that the level of good knowledge was 37%. There is a lack of information regarding knowledge and related factors of strabismus in the study area and limited in Ethiopia at large. Objective. The aim of this study was to asses knowledge about strabismus and associated factors among adults in Gondar town, Northwest Ethiopia. Methods. Community-based cross-sectional study was conducted using a pretested structured questionnaire through face to face interview from April 17 to May 01, 2019. Using multistage random sampling, 553 participants were included. Data from the entire questionnaire were coded, entered into Epi info version 7, and exported to SPSS version 20 for processing and analysis. Binary logistic regression was fitted, and variables with P value <0.05 in the multivariable logistic regression were considered as statistically significant. Results. A total of 553 adults with a response rate of 93.25% participated in the study. The median age was 33 (IQR = 14) years. Among the participants, 52.3% (95% CI: 47.9–56.4) had good knowledge towards strabismus. Being a student (AOR = 2.15, (95% CI: 1.11–4.13) was positively associated, while monthly income >5000 birrs (AOR = 0.44, 95% CI: 0.26–0.76) was negatively associated with good knowledge about strabismus. Conclusion. Almost half of the participants had good knowledge. Occupation and monthly income had a significant association with knowledge about strabismus. Since the source of information (TV/radio and Internet) was extremely important for the reliability and the level of knowledge, it is better to have sufficient media coverage.

The awareness of amblyopia among parents in Saudi Arabia

Purpose

Amblyopia is the most common cause of unilateral visual impairment. This study investigated parents' awareness of amblyopia in different regions of Saudi Arabia.

Methods

This was a cross-sectional population study. The survey consisted of two main sections; the first section contained 13 general background questions, and the second section (10 questions) focused on awareness of amblyopia, routine vision checks and how to raise awareness of amblyopia in the community. The survey was distributed to respondents using email and social media.

Results

The responses of 1649 families were received. Respondents' age range was from 22-62 years (mean ± standard deviation = 33.6 ± 8.7 years). Most respondents had no previous knowledge of amblyopia (1155 participants, 70%), and 313 participants (19%) had no idea if their children had amblyopia. In total, 990 participants (60%) did not visit the eye clinic with their children for a routine eye exam. A total of 495 parents (30%), who were aware of amblyopia, knew of it mainly from eye clinic visits and from Internet websites. A total of 140 respondents reported that their children had amblyopia; 58.3% of those children underwent routine eye examinations once a year, and the rest underwent routine eye examinations twice a year.

Conclusion

The results clearly showed a lack of amblyopia awareness among the Saudi community. This lack of awareness can lead to visual impairment among children. More efficient efforts are urgently needed from health professionals, education centres, the media and social organizations to promote awareness of amblyopia.

Uncertainty and self-efficacy in parents of a child with congenital cataract-New implications for clinical practice

AIM

The aim was an in-depth exploration of uncertainty and self-efficacy among parents of a child with congenital cataract by means of two theoretical frameworks to re-design family care.

DESIGN

A directed content analysis in accordance with Hsieh & Shannon, using Mishel's theory of uncertainty and Bandura's self-efficacy theory.

METHODS

Open-ended, in-depth interviews were conducted with 23 parents of a child with congenital cataract; six mothers, five fathers and six couples.

RESULTS

In this novel study, self-efficacy was interpreted as the ability to balance between uncertainty and acceptance. The performance accomplishment of the child and parents bridges the gap between uncertainty and acceptance by reducing uncertainty, thus constituting the level of self-efficacy. Setbacks and complications increase uncertainty and reduce self-efficacy, thus performance accomplishment is a mediator of self-efficacy, while ability to master uncertainty determines the level of self-efficacy.

[Do children with strabismus receive ophthalmic treatment? : Results from the KiGGS (German Health Interview and Examination Survey for Children and Adolescents) baseline survey (2003-2006)]

INTRODUCTION

Strabismus is a common cause for amblyopia and affected children need regular ophthalmic care. This study evaluated the frequency of ophthalmic care in children suffering from strabismus and analyzed associated factors.

METHODS

The data of the German Health Interview and Examination Survey for Children and Adolescents from the Robert Koch Institute (KiGGS, baseline survey 2003-2006, N = 17,640) were analyzed. Details on the presence of strabismus and the frequency of ophthalmic care were documented from information provided by the parents. Children aged 1-6 years were included. The relationship between strabismus and ophthalmic care in the previous 12 months was analyzed using multivariable logistic regression analysis and adjusted for age, sex, socioeconomic status, migration background, region and participation in regular pediatric check-ups.

RESULTS

A total of 5247 children were included in this study of which 3.0% (N = 175) were reported by the parents as suffering from strabismus. Ophthalmic care within the last 12 months was reported by 66.9% of the parents (95% confidence interval [CI] 54.7-77.2%) of children with strabismus and was more frequent compared to those without strabismus (19.7%, 95% CI 18.2-21.3%). Of the children with strabismus 33.8% had visited an ophthalmologist in the last 12 months once, 33.1% twice, 12.6% three times, 13.3% four times and 7.2% more than four times. There was a relationship between strabismus (odds ratio [OR] = 9.21, 95% CI 5.44-15.6) and ophthalmic care during the preceding year.

CONCLUSION

In Germany approximately one third of children with strabismus did not receive ophthalmic care within the previous year. This underlines the need for improvements in ophthalmic care in children with strabismus.

The prevalence of amblyopia in Iran: A systematic review

PURPOSE

The aim of this study was to determine the prevalence of amblyopia in the population of Iran.

METHODS

This article is a systematic review. A comprehensive search was conducted in PubMed, Scopus, Science Direct, Ovid, Web of Science, SID, Magiran, with appropriate terms. Information related to the sample size and the prevalence of amblyopia was extracted and summarized in tables. Analysis was performed using STATA software.

RESULTS

From 551 articles that were originally extracted from the databases, 31 articles met the criteria for entering the review. These studies were conducted in different regions of Iran. The prevalence of amblyopia in different regions varied between 0.19 and 3.69%. Study results were heterogeneous (I2 = 99.7%), and therefore, a meta-analysis was not done.

CONCLUSIONS

The prevalence of amblyopia in Iran is very different. In addition to conducting national screenings, it is necessary to report the incidence of amblyopia and its related factors in different parts of the country.