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Study: Cross-Eyed Kids Less Accepted by Peers

Researchers Urge Early Intervention to Align Children's Eyes
WebMD Health News
Reviewed by Laura J. Martin, MD

Aug. 18, 2010 -- Children with the eye condition strabismus, often called cross-eyed or squint, are less likely to be accepted by their peers, according to a new study.

"Negative attitudes appear to emerge at approximately 6 years and increase with age," write the Swiss researchers in the report of their study, published online in the British Journal of Ophthalmology.

In most cases, ''parents really should not wait longer than age 5 for surgery," researcher Daniel Stephane Mojon, MD, head of the department of strabismology and neuro-ophthalmology at Kantonsspital, St. Gallen, Switzerland, tells WebMD.

A U.S.-based expert says the study results are not surprising, but that there is good news. "Fortunately, strabismus is often a treatable condition," says James Plotnik, MD, a pediatric ophthalmologist in Scottsdale, Ariz., and a clinical correspondent for the American Academy of Ophthalmology, who reviewed the study for WebMD.

The study finding ''demonstrates another potential benefit of early intervention to align the eyes," Plotnik says.

Children With Strabismus: A Closer Look

Although research has found that adults with strabismus can be negatively affected psychologically, fewer studies have looked at children with the condition and how they are affected socially, according to the research team from the University of St. Gallen, University of Bern, and Kantonsspital.

Strabismus is common, Plotnik says, occurring in about 4% of children in the U.S. and sometimes also occurring later in life.

Crossed eyes is the most common form, Mojon says, although strabismus can describe eyes that turn outward, inward, up, or down.

Experts don't know the cause, but sometimes the condition is related to problems with the muscles that control eye movement.

The Swiss researchers gathered 118 children, ages 3 to 12, with an average age of 7, and showed them photographs of six identical twin pairs, half boys and half girls. The photos were digitally altered so that one child had misaligned eyes and a darker or lighter shirt.

The researchers asked the children which of the two ''twins'' they would invite to their birthday party. The children were asked to make a choice four different times, so that meant they could select the faces of up to four children with misaligned eyes.

How Strabismus Affects Children: Results

The children who were aged 6 and older were much less likely to invite a child with strabismus to their party.

Although only one of the 31 children aged 4 to 6 didn't select a single child with strabismus, 18 of the 48 children aged 6 to 8 did not.

None of the children aged 6 to 8 chose a child with strabismus all four times, but three of the children aged 4 to 6 did.

When asked if they noticed anything in particular about the twins, the percentage of kids who made specific comments about the eyes increased with age:

  • 19% of kids aged 4 to 6 commented on eye alignment without being asked to pay attention to eyes.
  • 48% of kids aged 6 to 8 commented on the eyes without being asked to notice eyes.

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