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1.
Health Qual Life Outcomes ; 17(1): 81, 2019 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-31064363

RESUMO

BACKGROUND: To estimate the effect of strabismus (squinting) on mental health and health-related quality of life aspects in children and adolescents. METHODS: Data from the German Health Interview and Examination Survey for Children and Adolescents KiGGS (2003-2006 baseline survey; N = 14,835, aged 3 to 17 years, 49% girls) were examined. The presence of strabismus was derived by parental questionnaire, and health-related quality of life and mental health were investigated with the KINDL-R and Strengths and Difficulties Questionnaire. Associations between strabismus and outcomes were analyzed using multivariable linear and logistic regression models. RESULTS: Of 12,989 children without missing data, 579 children (4.5% of the sample) were reported to have strabismus. Children with strabismus had lower scores in the parent-reported KINDL-R total scale (adjusted beta = - 1.02; 95%CI: -1.86 to - 0.18; p = 0.018) and sub-scale 'friends' (adjusted beta = - 2.18; 95%CI: -3.56 to -0.80; p = 0.002) compared to children without strabismus. The presence of strabismus was also associated with more mental health problems like 'hyperactivity/inattention' (adjusted OR = 1.50; 95%CI: 1.14 to 1.98; p = 0.005), and 'peer problems' (adjusted OR = 1.35; 95%-CI: 1.05 to 1.74; p = 0.018) as reported by parents. CONCLUSIONS: Strabismus in children and adolescents is associated with lower health-related quality of life.


Assuntos
Qualidade de Vida , Estrabismo/psicologia , Adolescente , Estudos de Casos e Controles , Criança , Transtornos do Comportamento Infantil/epidemiologia , Pré-Escolar , Estudos Transversais , Feminino , Inquéritos Epidemiológicos , Humanos , Lactente , Modelos Logísticos , Masculino , Pais/psicologia , Estrabismo/complicações , Inquéritos e Questionários
2.
Clin Neuroradiol ; 29(1): 87-94, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28913609

RESUMO

PURPOSE: Strabismus influences not only the individual with nonparallel eyes but also the observer. It has previously been demonstrated by fMRI that adults viewing images of strabismic adults have a negative reaction to the images as demonstrated by limbic activation, especially activation of the left amygdala. The aim of this study was to see if mothers would have a similar reaction to viewing strabismic children and whether or not that reaction would be different in mothers of strabismic children. METHODS: Healthy mothers of children with strabismus (n = 10, Group I) and without strabismus (n = 15, Group II) voluntarily underwent fMRI at 3T. Blood oxygen level dependent signal responses to viewing images of strabismic and non-strabismic children were analyzed. RESULTS: Group II, while viewing images of strabismic children, showed significantly increased activation of the limbic network (p < 0.05) and bilateral amygdala activation. Group I showed considerably less limbic activation, compared to the group II, and had no amygdala activation. Both groups revealed statically significant activation in the FEF (frontal eye field) when they were viewing images of strabismic children as compared to when they were viewing children with parallel eyes. The activated FEF area for Group II was much larger than for group I. CONCLUSION: Mothers of non-strabismic children showed similar negative emotional fMRI patterns as adults did while viewing strabismic adults. Strabismus is an interpersonal organic issue for the observer, which also impacts the youngest members of our society.


Assuntos
Emoções/fisiologia , Sistema Límbico/fisiologia , Imagem por Ressonância Magnética/métodos , Mães/psicologia , Estrabismo/psicologia , Adulto , Tonsila do Cerebelo/fisiologia , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Oxigênio/sangue , Fotografação
3.
Medisan ; 22(9)nov.-dic. 2018. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-976171

RESUMO

Se efectuó un estudio longitudinal, prospectivo y comparativo de 43 adultos con estrabismo, quienes acudieron al Servicio de Oftalmología del Hospital Infantil Sur de Santiago de Cuba, desde enero del 2015 hasta mayo del 2017, a fin de valorar su autoestima. A todos se les realizó un examen oftalmológico completo, que mostró el grado de desviación media antes y después de la cirugía. Se les aplicó una prueba de autoestima de Rosenberg, previa a la intervención y 2 meses después de esta. Prevalecieron el sexo femenino, la edad media de 48,5 años y la exotropía. Antes de la cirugía, el nivel de autoestima estuvo por debajo de 25 puntos en la mayoría de los pacientes (81,3 por ciento); sin embargo, posterior a esta fue baja en solo 2,3 por ciento y normal en 90,6 por ciento, lo que causó un impacto favorable en la calidad de vida e integración social de los afectados.


A longitudinal, prospective and comparative study of 43 adults with strabismus who went to the Ophthalmology Service of the Southern Pediatric Hospital in Santiago de Cuba, from January, 2015 to May, 2017 was carried out, in order to evaluate their self-esteem. A complete ophthalmological exam was carried out to all, which showed the average deviation degree before and after surgery. A Rosenberg self-esteem test was applied, previous to the intervention and 2 months after it. The female sex, the mean age of 48.5 years and the exotropy prevailed. Before surgery, the self-esteem level was below 25 points in most of the patients (81.3 percent); however, after this it was low in only 2.3 percent and normal in 90.6 percent, what caused a favourable impact in the life quality and social integration of the affected patients.


Assuntos
Humanos , Masculino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Autoimagem , Estrabismo/psicologia , Escala de Avaliação Comportamental , Atenção Secundária à Saúde , Exotropia
4.
Health Qual Life Outcomes ; 16(1): 171, 2018 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-30176900

RESUMO

BACKGROUND: Substantial challenges have been reported in China in terms of the large number of adult patients with strabismus and their poor quality of life. Quality of life is a cultural concept that varies according to personal feelings and perceptions, and it is influenced by physical, psychological and social factors. However, to date, there has been no mixed-method research of the quality of life of Chinese adult patients with strabismus, and no conceptual model has been reported. This study aimed to utilize mixed methods to explore the influence of strabismus on health-related quality of life in Chinese adult patients and to develop a conceptual model. METHODS: Thirty adult patients with strabismus from three tertiary hospitals in China participated in the interview. In-depth one-to-one interviews were semi-structured and addressed strabismus-related symptoms and the impacts on the participants' quality of life. Transcripts were analysed to identify themes. A self-designed questionnaire was distributed to 448 patients, 437 of whom returned valid questionnaires. Descriptive statistics and x2 test were conducted. RESULTS: Five themes were revealed regarding the impact of strabismus on patient quality of life: appearance, daily activities, personal development, social interaction, and emotions. In the survey, the top three symptoms (n ≥ 70%) rated by the participants were monocular vision, eye fatigue and physical discomfort. Compared to those without diplopia, the patients who suffered diplopia more often reported experiencing the symptoms of blurred vision, monocular vision, physical discomfort, eye fatigue, cannot estimate depth well and increasing deviation size (all p < 0.05). CONCLUSIONS: This study is the first to examine quality of life among Chinese strabismus patients using both qualitative and quantitative methods and proposing a conceptual model. Symptom burden and appearance were the two original reasons for the decreased quality of life, and they were also the triggers for strabismus patients to visit clinics and undergo surgery. The interventions to treat symptoms burden should be different between patients with and without diplopia.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Qualidade de Vida/psicologia , Autorrelato , Estrabismo/psicologia , Adulto , China , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença
5.
J AAPOS ; 22(4): 266-271.e3, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30003957

RESUMO

PURPOSE: To explore factors that influence the success of adult strabismus surgery based on health-related quality of life (HRQOL) criteria. METHODS: The HRQOL aspect of strabismus surgery was assessed using the Adult Strabismus 20 (AS-20) questionnaire. Adult patients (≥16 years of age) undergoing strabismus surgery between 2014 and 2016 were identified using a treatment register. Pre- and postoperative AS-20 scores were calculated. HRQOL surgical success was defined as a pre- to postoperative change in AS-20 score exceeding previously published 95% limits of agreement. Any relationship between demographic factors (sex, age, and socioeconomic status), presence or absence of diplopia, type and magnitude of deviation, and change in deviation size with HRQOL success was investigated. RESULTS: A total of 87 patients were included (mean age, 47 years; 53% female). Nondiplopic patients showed significantly lower pre- and postoperative scores on the AS-20 psychosocial subscale compared to diplopic patients. Of 87 surgeries, 54 (62%) were classified as successful based on HRQOL criteria. Multiple logistic regression analysis showed only lower socioeconomic status to be significantly associated with a higher rate of HRQOL success (P = 0.04). CONCLUSIONS: Strabismic patients with a lower socioeconomic status are more likely to achieve HRQOL success following surgery. We also show that nondiplopic patients have more psychosocial concerns than those with diplopia and that this disparity persists even after strabismus surgery.


Assuntos
Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Estrabismo/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Nível de Saúde , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Fatores de Risco , Fatores Socioeconômicos , Estrabismo/psicologia , Acuidade Visual , Adulto Jovem
6.
J AAPOS ; 22(3): 170-173.e1, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29654908

RESUMO

BACKGROUND: The psychosocial and functional impact of strabismus among the elderly is increasingly important as life expectancy increases and factors that enhance the quality of life become more significant. The purpose of this study was to characterize the demographics, presenting complaints, health status, underlying etiology, and outcomes of strabismus surgery in three age cohorts of Medicare-aged patients. METHODS: The medical records of patients at least 65 years of age who underwent strabismus surgery between 2004 and 2015 in a university-based strabismus practice were reviewed retrospectively. RESULTS: A total of 110 patients were identified and divided into three age cohorts for analysis: young-old (age 65-74), middle-old (age 75-84), and old-old (age 85+). At least 75% of patients in all cohorts cited diplopia as their chief complaint (P = 0.87). There was no difference in sex distribution, type of deviation, underlying etiology, or preoperative American Society of Anesthesiologists physical status classification scores between the cohorts (P = 0.68, P = 0.53, P = 0.71, P = 0.93, resp.). By the 6- to 8-week postoperative visit, 63% of all patients reported complete resolution of their presenting chief complaint, 23% reported some improvement, and 11% reported no improvement, with no difference between the cohorts (P = 0.12). CONCLUSIONS: Given the functional and psychosocial impact of strabismus in the elderly, this study lends support to consideration of surgery as a viable option to successfully treat strabismus among the oldest age cohorts.


Assuntos
Medicare/estatística & dados numéricos , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Estrabismo/cirurgia , Idoso , Idoso de 80 Anos ou mais , Diplopia/fisiopatologia , Feminino , Nível de Saúde , Humanos , Masculino , Músculos Oculomotores/fisiopatologia , Qualidade de Vida/psicologia , Estudos Retrospectivos , Perfil de Impacto da Doença , Estrabismo/fisiopatologia , Estrabismo/psicologia , Inquéritos e Questionários , Resultado do Tratamento , Estados Unidos/epidemiologia , Visão Binocular/fisiologia , Acuidade Visual/fisiologia
8.
Clin Exp Optom ; 101(4): 460-484, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-28636173

RESUMO

BACKGROUND: Many patient-reported outcome measures (PROMs) have been developed and/or used to measure the impact of amblyopia and strabismus on quality of life (QoL). Identifying the one with superior quality is important for evaluating the effectiveness of novel therapy for amblyopia and for directing improved clinical decision-making in adults considering strabismic surgery. Therefore, the aim of this review is to identify all PROMs previously developed/used to study the impact of amblyopia and/or strabismus on QoL and to appraise the quality and comprehensiveness of content of the disease-specific instruments. METHODS: A systematic search was carried out in the electronic databases of PubMed, Cochrane, Web of Science and PsycINFO. The quality of content and measurement properties of all the disease-specific instruments were assessed using established quality standards. Further, the content of the instruments were examined for comprehensiveness by categorising each item across the eight ophthalmic QoL domains (activity limitation, concerns, emotional well-being, social well-being, economic, convenience, symptoms and mobility). RESULTS: Seventy-one PROMs were identified, out of which 32 were amblyopia- and/or strabismus-specific. Out of all the disease-specific instruments, just four have been subjected to modern psychometric tests and only the adult strabismus questionnaire (AS-20) demonstrated good measurement properties. Most of the amblyopia-specific instruments measured the impact of the treatment of amblyopia on children, while most of the strabismus-specific instruments measured concerns related to appearance and treatment outcome in adults. All instruments have gaps in their content and failed to address QoL comprehensively. CONCLUSION: All the existing amblyopia- and/or strabismus-specific instruments fall short of desired quality and/or comprehensiveness of content. The review identifies the need for developing an instrument with superior quality and discusses potential directions of future research.


Assuntos
Ambliopia/psicologia , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida/psicologia , Estrabismo/psicologia , Ambliopia/cirurgia , Bases de Dados Factuais , Humanos , Psicometria , Estrabismo/cirurgia , Inquéritos e Questionários
9.
Semin Ophthalmol ; 33(2): 149-154, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-27599387

RESUMO

PURPOSE: Ophthalmic problems are reported to be common in children with autism spectrum disorder (ASD), and strabismus is of particular importance. We aimed to investigate the outcomes of strabismus management in cases with ASD and identify the impact of optical or surgical correction of the strabismus on the child using a questionnaire for parents. METHODS: A survey was designed to assess parents' perceptions of pre-management and post-management quality of life in 41 children aged 5-17 years with ASD and strabismus using a questionnaire with 10 questions, including three subscales. RESULTS: Significant improvements were noted after management in functional limitations (P < 0.01), psychosocial interactions (P < 0.01), and ocular alignment (P < 0.01) subscales. CONCLUSION: This is the first study of the literature that investigated the impact of ocular re-alignment on behavioral patterns and social interactions of children with ASD and strabismus.


Assuntos
Transtorno do Espectro Autista/psicologia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Oftalmologistas , Pais , Qualidade de Vida , Estrabismo/cirurgia , Inquéritos e Questionários , Adolescente , Transtorno do Espectro Autista/complicações , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Masculino , Estudos Retrospectivos , Estrabismo/complicações , Estrabismo/psicologia , Resultado do Tratamento
10.
Neurosci Lett ; 656: 22-30, 2017 Aug 24.
Artigo em Inglês | MEDLINE | ID: mdl-28729073

RESUMO

INTRODUCTION: The purpose was to investigate the effect of vergence reeducation on postural control, in subjects with isolated vergence disorders. MATERIAL AND METHODS: We studied the dynamics of vergence in 19 subjects (20-44 years old) using video-oculography (Eye See Cam). On the basis of orthoptic and symptomatology assessments, ten of the subjects were diagnosed for vergence disorders then vergence eye movements were reeducated with the REMOBI method (US8851669, 5 weekly sessions lasting for 35min). Postural control was measured before and after reeducation, postural recording was done in upright stance (Dynaport), with both eyes closed or open and looking a visual target located at 2m distance. RESULTS: After reeducation with REMOBI, the visual symptomatology faded away and the stereoacuity improved at least for some subjects; the vergence latency decreased significantly and the vergence accuracy increased significantly. In terms of posture, the Mean Power Frequency (MPF) of the body sway decreased significantly in both eyes open and eyes closed conditions. Considering all subjects together (i.e. healthy subjects and subjects with vergence disorders before the reeducation), the antero-posterior body sway (Root Mean Square A/P) was positively correlated with the visual symptomatology: the higher the visual symptomatology, the higher was the body sway. CONCLUSION: The results bring evidence for synergy between the quality of vergence and the quality of postural control. They open a new research line that bridges the gap between neuroscience, ophthalmology-orthoptics and posturology.


Assuntos
Convergência Ocular , Equilíbrio Postural , Estrabismo/reabilitação , Adulto , Feminino , Humanos , Masculino , Estrabismo/fisiopatologia , Estrabismo/psicologia
11.
Indian J Ophthalmol ; 65(7): 603-606, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28724818

RESUMO

PURPOSE: Strabismus and anisometropia are the most common causes of amblyopia. It can be easily prevented or treated if detected early. With the changing socio-cultural-economic milieu of the society, the perspectives of strabismus in society are gradually changing but still adequate knowledge, awareness, and attitude of parents toward strabismus will help in preventing amblyopia and aid in the proper psychosocial adaptation of such children. This study aimed to assess knowledge and attitude of parents toward children suffering from strabismus. METHODS: A prospective study was carried out from January 1 to February 29, 2016, through a structured questionnaire to assess the level of knowledge and attitude of parents of children suffering from strabismus. RESULTS: One hundred and twenty parents of children with strabismus were interviewed through a questionnaire. Education level of 78 parents was less than graduation (60%) and of 42 parents (40%) was graduation or higher. The majority of the parents, i.e., 116 (96.67%) were bothered due to strabismus. One hundred and one (84.17%) parents felt that their child's strabismus was noticed by others during interaction. Seventy-four (61.67%) parents felt that their children will have difficulty in making friends. Ninety (75%) parents felt uncomfortable if someone asked something about their child's strabismus. One hundred and ten (91.67%) parents considered strabismus as cosmetic stigma. CONCLUSION: Some parents, especially from the lower educated segment, had poor understanding of strabismus, thus resulting in late presentation and ineffective countermeasures. The key to prevent strabismic amblyopia and its psychosocial impacts is to provide health education regarding strabismus.


Assuntos
Adaptação Psicológica , Atitude Frente a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Pais/educação , Estrabismo/psicologia , Pré-Escolar , Feminino , Humanos , Incidência , Índia/epidemiologia , Lactente , Masculino , Pais/psicologia , Estudos Prospectivos , Estrabismo/epidemiologia , Estrabismo/terapia , Inquéritos e Questionários
12.
Graefes Arch Clin Exp Ophthalmol ; 255(9): 1851-1858, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28555418

RESUMO

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.


Assuntos
Ambliopia/psicologia , Percepção de Profundidade/fisiologia , Qualidade de Vida , Perfil de Impacto da Doença , Estrabismo/psicologia , Visão Binocular/fisiologia , Adulto , Ambliopia/fisiopatologia , Estudos Transversais , Análise Fatorial , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Estrabismo/fisiopatologia , Acuidade Visual
13.
Turk J Med Sci ; 47(2): 483-489, 2017 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-28425235

RESUMO

BACKGROUND/AIM: This study aims to evaluate the reliability and validity of the Amblyopia and Strabismus Questionnaire (AandSQ) that is translated into Turkish. MATERIALS AND METHODS: This is a methodological study. A total of 149 patients took part in the survey research between December 2012 and June 2014 in an university hospital, and 37 were retested. Cronbach's alpha coefficient was used for the questionnaire's reliability analysis. RESULTS: Cronbach's alpha coefficients for the subscales of fear of losing the better eye, distance estimation, visual disorientation, double vision, and social contact and appearance were found to be 0.80, 0.88, 0.95, 0.80, and 0.81, respectively. Five factors determined by the exploratory factor analysis explained 69.87% of the total variance. CONCLUSION: The Turkish version of the AandSQ is found as a reliable and valid scale for analyzing Turkish society. The AandSQ might be helpful for measuring quality of life in patients with strabismus.


Assuntos
Ambliopia/diagnóstico , Ambliopia/psicologia , Estrabismo/diagnóstico , Estrabismo/psicologia , Inquéritos e Questionários/normas , Traduções , Acuidade Visual/fisiologia , Adulto , Ambliopia/fisiopatologia , Análise Fatorial , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Estrabismo/fisiopatologia , Turquia , Visão Binocular/fisiologia , Adulto Jovem
14.
Strabismus ; 25(1): 33-38, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28166429

RESUMO

BACKGROUND: A rating scale is a critical component of patient-reported outcome instrument design, but the optimal rating scale format for pediatric use has not been investigated. We compared rating scale performance when administering potential questionnaire items to children with eye disorders and their parents. METHODS: Three commonly used rating scales were evaluated: frequency (never, sometimes, often, always), severity (not at all, a little, some, a lot), and difficulty (not difficult, a little difficult, difficult, very difficult). Ten patient-derived items were formatted for each rating scale, and rating scale testing order was randomized. Both child and parent were asked to comment on any problems with, or a preference for, a particular scale. Any confusion about options or inability to answer was recorded. RESULTS: Twenty-one children, aged 5-17 years, with strabismus, amblyopia, or refractive error were recruited, each with one of their parents. Of the first 10 children, 4 (40%) had problems using the difficulty scale, compared with 1 (10%) using frequency, and none using severity. The difficulty scale was modified, replacing the word "difficult" with "hard." Eleven additional children (plus parents) then completed all 3 questionnaires. No children had problems using any scale. Four (36%) parents had problems using the difficulty ("hard") scale and 1 (9%) with frequency. Regarding preference, 6 (55%) of 11 children and 5 (50%) of 10 parents preferred using the frequency scale. CONCLUSIONS: Children and parents found the frequency scale and question format to be the most easily understood. Children and parents also expressed preference for the frequency scale, compared with the difficulty and severity scales. We recommend frequency rating scales for patient-reported outcome measures in pediatric populations.


Assuntos
Ambliopia/psicologia , Medidas de Resultados Relatados pelo Paciente , Erros de Refração/psicologia , Índice de Gravidade de Doença , Perfil de Impacto da Doença , Estrabismo/psicologia , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Qualidade de Vida
16.
Korean J Ophthalmol ; 30(6): 410-415, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27980359

RESUMO

PURPOSE: To evaluate differences in self-identity in patients diagnosed with strabismus, patients who underwent strabismus surgery, and healthy control individuals. METHODS: Self-identity testing was done during a military service physical examination. There were three subject groups: subjects with strabismus (group 1), subjects who had undergone corrective strabismus surgery (group 2), and subjects free of strabismus (group 3). The self-identity test was comprised of six sub-sections (subjectivity, self-acceptance, future confidence, goal orientation, initiative, and familiarity). Statistical significance of the sub-sections was compared across the three groups. Correlations in age at the time of surgery and across the six sub-sections were investigated in group 2. RESULTS: A total of 351 subjects were enrolled in the study; 96 subjects were in group 1, 108 subjects were in group 2, and 147 subjects were in group 3. Significant differences were evident in subjectivity, self-acceptance, initiative and familiarity between groups 1 and 3. No significant differences were found between groups 2 and 3. In group 2, statistical significance was evident between age at surgery and initiative and familiarity (r = -0.333, p < 0.001; r = -0.433, p < 0.001, respectively). CONCLUSIONS: Self-identity is greater in non-strabismus subjects than strabismus subjects. Correction of strabismus may increase self-identity levels.


Assuntos
Movimentos Oculares/fisiologia , Expressão Facial , Músculos Oculomotores/fisiopatologia , Autoimagem , Estrabismo/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Estudos Retrospectivos , Estrabismo/fisiopatologia , Estrabismo/cirurgia
17.
J AAPOS ; 20(5): 383-386, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27651232

RESUMO

BACKGROUND: Strabismus, which has been estimated to occur in 4% of the adult population, can have a negative psychosocial effect on an individual's quality of life. While correction of strabismus may improve quality of life, this is not always the case, even if realignment surgery is clinically successful. Surgeons need to understand patients' expectations of postsurgical outcomes and the impact surgery has on their psychosocial well-being. METHODS: This was a prospective cross-sectional study of 220 adult patients undergoing strabismus surgery at Moorfields Eye Hospital NHS Foundation Trust. Clinical assessments were performed before surgery and again 2 weeks and 3 months after surgery. Standardized psychological questionnaires were completed preoperatively and 3 and 6 months postoperatively. RESULTS: Of 220 patients included in the study (mean age, 45 years), 54% were female, 81% were white, and 58.6% had a concomitant deviation. Prior to surgery, 24% of study participants were experiencing clinical levels of anxiety; 11% were suffering clinical levels of depression. Quality of life improved and anxiety and depression were reduced after surgery. Approximately 6% of the sample regretted having undergone surgery either at 3 or 6 months after treatment. CONCLUSIONS: It is important to identify patients who are experiencing significant psychosocial distress and to assess their postsurgical expectations in order to improve the outcomes of strabismus surgery. Presurgical psychosocial support should be considered for these patients.


Assuntos
Transtornos de Ansiedade/psicologia , Transtornos do Humor/psicologia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/psicologia , Estrabismo/psicologia , Estrabismo/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida/psicologia , Estresse Fisiológico/fisiologia , Inquéritos e Questionários , Adulto Jovem
18.
Cochrane Database Syst Rev ; (5): CD010092, 2016 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-27171652

RESUMO

BACKGROUND: Strabismus, also known as squint, can have a debilitating effect on a person's self-esteem, quality of life and mood, as well as increase their feelings of social anxiety and avoidance behaviour. Strabismus surgery can improve both the alignment of a person's eyes and, in appropriate cases, relieve symptoms such as double vision. However, evidence indicates that not all patients experience a meaningful improvement in their quality of life postsurgery. Pre-surgical psychosocial interventions have been found to improve patient reported outcomes in other long-term conditions. OBJECTIVES: To assess the effects of psychosocial interventions versus no intervention on quality of life and psychosocial outcomes in adults undergoing strabismus surgery. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision group Trials Register) (2016, Issue 1), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to February 2016), EMBASE (January 1980 to February 2016), Latin American and Caribbean Health Sciences (LILACS) (January 1982 to February 2016), PsycINFO (January 1967 to February 2016), the ISRCTN registry (www.isrctn.com/editAdvancedSearch), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 15 February 2016.We also manually searched the British Orthoptic Journal, proceedings of the European Strabismological Association (ESA), International Strabismological Association (ISA) and published transactions from the meetings of European Strabismus Association (ESA) and American Association for Pediatric Ophthalmology and Strabismus (AAPOS). These were searched from 1980 to present. We also carried out handsearches of Psychology and Health, British Journal of Health Psychology, Health Psychology and Annals of Behavioral Medicine. SELECTION CRITERIA: We planned to include randomised controlled trials (RCTs), including cluster-RCTs, in which effectiveness of a psychosocial intervention had been evaluated in patients due to undergo strabismus surgery. DATA COLLECTION AND ANALYSIS: Two review authors independently reviewed the search results for eligibility. MAIN RESULTS: None of the 88 studies we identified met the inclusion criteria of this Cochrane review. AUTHORS' CONCLUSIONS: We found no evidence that evaluated the impact of psychosocial interventions on patients undergoing squint surgery. We believe future research should focus on developing and evaluating the use of targeted psychosocial interventions to improve a patient's quality of life after strabismus surgery.


Assuntos
Qualidade de Vida , Estrabismo/cirurgia , Adulto , Humanos , Estrabismo/psicologia
19.
Eye (Lond) ; 30(5): 656-67, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27126298

RESUMO

AimsTo establish the impact of adult strabismus surgery on clinical and psychosocial well-being and determine who experiences the greatest benefit from surgery and how one could intervene to improve quality of life post-surgery.MethodsA longitudinal study, with measurements taken pre-surgery and at 3 and 6 months post-surgery. All participants completed the AS-20 a disease specific quality of life scale, along with measures of mood, strabismus and appearance-related beliefs and cognitions and perceived social support. Participants also underwent a full orthoptic assessment at their preoperative visit and again 3 months postoperatively. Clinical outcomes of surgery were classified as success, partial success or failure, using the largest angle of deviation, diplopia and requirement for further therapy.Results210 participants took part in the study. Strabismus surgery led to statistically significant improvements in psychosocial and functional quality of life. Those whose surgery was deemed a partial success did however experience a deterioration in quality of life. A combination of clinical variables, high expectations, and negative beliefs about the illness and appearance pre-surgery were significant predictors of change in quality of life from pre- to post-surgery.ConclusionsStrabismus surgery leads to significant improvements in quality of life up to 6 months postoperatively. There are however a group of patients who do not experience these benefits. A series of clinical and psychosocial factors have now been identified, which will enable clinicians to identify patients who may be vulnerable to poorer outcomes post-surgery and allow for the development of interventions to improve quality of life after surgery.


Assuntos
Transtornos do Humor/psicologia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Qualidade de Vida/psicologia , Estrabismo/psicologia , Estrabismo/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/fisiopatologia , Transtornos de Ansiedade/psicologia , Transtorno Depressivo/fisiopatologia , Transtorno Depressivo/psicologia , Feminino , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/fisiopatologia , Músculos Oculomotores/fisiopatologia , Satisfação do Paciente , Perfil de Impacto da Doença , Apoio Social , Estrabismo/fisiopatologia , Inquéritos e Questionários
20.
Neurosci Lett ; 623: 28-35, 2016 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-27109787

RESUMO

Few studies have investigated the relationship between strabismus and balance, and those that do exist focused on patients within a limited age range, while no studies on possible age-related changes have yet been conducted. Therefore, the aim of our study was to investigate whether the balance strategies adopted by patients with congenital or early onset strabismus change with age. Forty strabismic patients and 36 healthy subjects were enrolled in the study. Both patients and healthy subjects were divided into three subgroups according to age (children, adolescents, and adults) and underwent a stabilometric evaluation. When we compared the whole group of strabismic patients with the group of healthy subjects, we found that the center of pressure area and the trunk oscillations in the former were significantly different from those in the latter; when we considered the three age groups separately, only values in children with strabismus were different from those in the age-matched control group of healthy subjects. Strabismus was found to affect balance in children by inducing a postural strategy characterized by a reduction in physiological trunk oscillations. Gaining a better insight into postural control in strabismic subjects and its evolution with age may be crucial to improving rehabilitation in such patients and planning tailored rehabilitation treatment.


Assuntos
Equilíbrio Postural , Estrabismo/psicologia , Adolescente , Adulto , Fatores Etários , Idade de Início , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estrabismo/congênito , Adulto Jovem
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