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HRQOL linked to clinical severity of intermittent exotropia in children

19 Aug 2019

The health-related quality of life (HRQOL) of both the child and their parents appear to be associated with clinical severity of intermittent exotropia in children, reports a study.

The authors sought to determine whether the results of the HRQOL correlated with the different clinical aspects of intermittent exotropia in children. They prospectively evaluated the HRQOL of children and their parents using the Intermittent Exotropia Questionnaire (IXTQ), as well as measured the deviation angle, stereo function, sensory fusion and strabismus control.

A total of 266 children with intermittent exotropia (aged 5–17 years) participated in this study. A significant association was found between child HRQOL and clinical severity. Lower IXTQ scores correlated with a larger deviation (p<0.001 both for distance and near) and poorer Newcastle control scores (p<0.001).

Proxy child HRQOL was significantly associated with the deviation (p<0.001), Newcastle control scores (p<0.001) and stereo function (p<0.05), while parent HRQOL correlated with their child’s deviation (p<0.01) and stereo function (p<0.005).

The child’s HRQOL was also associated with the deviation angle at distance and the Newcastle control score at home in multiple linear regression analysis.

“Large deviation, poor control and poor stereo function were significantly associated with lower IXTQ scores,” the authors said. “The deviation angle at distance and exotropia control at home were associated with the child’s HRQOL.”

An earlier study showed that while it is difficult to predict child HRQOL based on clinical measurements, parent HRQOL tends to be worse with poorer control and larger angle of deviation. Researchers suggested that HRQOL be routinely assessed in clinic alongside clinical measurements to tailor management accordingly. [Br J Ophthalmol 2015;99:1405-1411]

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