Strabismus may be associated with mental illness in children
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Children with strabismus may be at an increased risk for mental illness, according to a large cross-sectional study. A moderate association was found between strabismus and anxiety disorder, schizophrenia, depression and bipolar disorder.
Children with strabismus experience increased difficulties with schoolwork, teasing and social exclusion by peers, and problems with self-image. Theoretically, this may expose them to a higher risk of developing mental illness, but so far studies on this subject have been based on small, geographically limited cohorts.
This new study used a large data set of 12,005,189 children included in the OptumLabs Data Warehouse, the largest available private health insurance claims database, representing a range of ages, ethnicities and U.S. geographic regions. Overall, 352,636 children had strabismus, while 11,652,553 had no eye disease and were used as controls.
Data analysis showed that the odds of having psychiatric diagnoses, including anxiety disorder, schizophrenia, depression and bipolar disorder, were higher in children with strabismus, with an adjusted odds ratio ranging from 1.61 to 2.01.
Future studies need to explore the association between strabismus and various mental illnesses and to investigate whether there is a prevalently social or genetic basis for this association. It would also be useful to find out whether correction of strabismus may help mental illness, the authors wrote.
However, recognizing that this association exists is important and may determine changes in clinical practice.
“These results should alert ophthalmologists and optometrists to counsel children and their caregivers regarding the risk for mental illness. They should consider incorporating a screening tool for mental health problems for patients with strabismus and referral of pediatric patients with strabismus for mental health evaluation,” the authors wrote.
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