title: Childhood intermittent exotropia from a different angle: does severity affect quality of life?
abstract: BACKGROUND
  Few studies have explored the relationship between health-related quality of life (HRQOL) and clinical severity of childhood intermittent exotropia (IXT) measured by angle of deviation, control and stereoacuity.
  
  
  METHODS
  Sixty-eight consecutive children aged 5-17 years with childhood IXT who attended the paediatric eye clinic were recruited. One accompanying parent was recruited concurrently. Child, parent and proxy (parent about the child) HRQOL was measured using the IXT questionnaire (IXTQ). Angle of deviation, control and stereoacuity of the children were measured and correlated with IXTQ scores using Spearman's correlation coefficient and paired t test for differences in child and proxy IXTQ mean scores.
  
  
  RESULTS
  The mean age of the children was 9.0±2.6 years. Child HRQOL was not correlated to any strabismus measurements. Poorer parent HRQOL was correlated with poorer distance control (surgery subscale, r=-0.24 p=0.049), poorer near control (surgery subscale, r=-0.30, p=0.013), poorer office near control (mean, r=-0.24, p=0.047; psychological subscale, r=-0.27, p=0.025; surgery subscale, r=-0.28, p=0.020) and larger angle of deviation (psychological subscale, r=-0.30, p=0.013). Poorer proxy HRQOL was correlated with poorer home control (r=-0.28, p=0.022) and larger angle of deviation (r=0.33, p=0.0061).
  
  
  CONCLUSIONS
  It is difficult to predict child HRQOL based on clinical measurements. However, parent HRQOL tends to be worse with poorer control and larger angle of deviation. Perhaps HRQOL should be routinely assessed in clinic alongside clinical measurements in order to tailor management appropriately.
authors: Department of Ophthalmology, National University Hospital, Singapore University of Cambridge School of Medicine, Cambridge, UK.
authors: S B
authors: SB
authors: Lim
authors: Department of Ophthalmology, National University Hospital, Singapore Singapore Eye Research Institute, Singapore.
authors: W L
authors: WL
authors: Wong
authors: Department of Psychological Medicine, National University Hospital, Singapore.
authors: R C
authors: RC
authors: Ho
authors: Department of Ophthalmology, National University Hospital, Singapore.
authors: I B
authors: IB
authors: Wong
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005099:Exotropia / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Child health (paediatrics); Muscles