title: Health-Related Quality of Life (HRQoL) in Young Adults with Strabismus in India.
abstract: BACKGROUND
  Strabismus has negative psycho-social and functional effects in adults. The impact can be minimised with surgery. However, in a low-income setting, it is important to evaluate the level of impact and prioritise the target population for intervention. The Adult Strabismus (AS-20) questionnaire is a reliable tool for assessment of Health-Related Quality of Life (HRQoL) in strabismic adults.
  
  
  OBJECTIVE
  To assess the HRQoL in young adults with manifest strabismus through psychosocial and functional scores according to gender and direction of deviation using the AS-20 questionnaire.
  
  
  METHODS
  In this cross-sectional cohort study, 132 young adults who manifest horizontal strabismus were recruited and the AS-20 questionnaire was administered. Patient's demographic profile and type of strabismus were noted and compared with the overall mean scores of psycho-social and functional subscales. Data was analyzed using SPSS 21 and p-value less than 0.05 was considered statistically significant.
  
  
  RESULTS
  The participants comprised of 70 (53.03%) males and 62 (46.97%) females with a mean age of 24.5±3.57 years (range 18 to 38 years). The overall mean AS-20 score of young adults with strabismus was 61.62±12.61. The overall mean score for male and female were 65.54±13.53 and 57.68±13.46, respectively. Similarly, the mean scores for esotropes was 57.03±11.66 and 66.19±15.30 for exotropes. The overall mean scores were statistically significantly reduced (decreased QoL) in females as compared to males (CI 95%; p=0.002) and in esotropes as compared to exotropes (CI 95%; p=0.001). However, there was no significant difference between the psychosocial and functional score for all types of strabismus and genders (for all, p>0.05).
  
  
  CONCLUSIONS
  The Quality of Life (QoL) is affected through psychosocial and functional factors in adults with strabismus. Females and adults with esotropia faced greater difficulties in the QoL. We recommend clinicians to consider the impact on QoL while managing adult with strabismus.
authors.affiliation: Optometrist, Department of Optometry and Vision Science, Amity Medical School, Amity University , Gurgaon, Haryana, India .
authors.forename: Surendra P
authors.initials: SP
authors.lastname: Sah
authors.affiliation: Optometrist, Department of Optometry and Vision Science, Amity Medical School, Amity University , Gurgaon, Haryana, India .
authors.forename: Indra P
authors.initials: IP
authors.lastname: Sharma
authors.affiliation: Professor, Department of Optometry and Vision Science, Amity Medical School, Amity University , Gurgaon, Haryana, India .
authors.forename: Monica
authors.initials: M
authors.lastname: Chaudhry
authors.affiliation: Assistant Professor, Department of Optometry and Vision Science, Amity Medical School, Amity University , Gurgaon, Haryana, India .
authors.forename: Mousumi
authors.initials: M
authors.lastname: Saikia
keywords: Adult strabismus questionnaire; Esotropia; Exotropia