Clinical Study On The Quality Of Life And Its Relationship With The Deviation Angle Of Childhood Intermittent Exotropia

Purpose:To assess and compare the quality of life(QOL)of children with intermittent exotropia(IXT)and normal children using the Intermittent Exotropia Questionnaire(IXTQ).To further study the relationship between QOL and the deviation angle of IXT children and parents by IXTQ scores.Methods:Questionnaire survey was conducted on 68 patients diagnosed with IXT and 68 normal children,One accompanying parent was recruited concurrently.The scale including Child IXTQ,Proxy IXTQ and Parent IXTQ.The Child IXTQ and Proxy IXTQ including visual and psychosocial dimensions,while the Parent IXTQ including function,social psychology and surgery dimensions.The differences of IXTQ scores between the case and the normal control group were compared.The deviation angle was measured at distance(5m)and near(33cm)using prism alternate cover test(PACT),and divided into three groups accordingly: 20?PD<40,40 ?PD<60,PD?60.The IXTQ scores in different groups were compared.Results:1.The scores of Child IXTQ,Proxy IXTQ and Parent IXTQ in case group were lower than those of the control group.The scores of visual function items in Child IXTQ were of significant differences between the case and control(P<0.05),such as closure of one eye in bright sunlight(62.50 ± 32.46 vs 85.61 ± 24.04),worry about the eyes(51.84± 27.08 vs 70.83 ± 31.19),while the scores of social psychological items were of no statistical difference,such as ridicule,dating difficulties,worry about the views of others.The scores in Parent IXTQ were of significant differences between the case and control(P<0.05),such as visual function(49.21 ± 23.13 vs 90.12 ± 18.83),social psychology(59.97 ± 22.15 vs 91.02 ± 15.31)and surgical dimensions(52.02 ± 28.12 vs 86.74 ± 15.48).2.In different groups of deviation angle of distance,there were significant differences between the scores of Proxy IXTQ and Parent IXTQ(F=3.416,P=0.039;F=4.197,P= 0.019),while the scores of Child IXTQ among these three groups were of no statistical difference.In different groups of deviation angle of near,there were significant differences between the scores of Proxy IXTQ and Parent IXTQ(F=6.086,P=0.004;F=3.295,P=0.043),while the scores of Child IXTQ among these three groups were of no statistical difference.3.The scores of Child IXTQ were not correlated to the angle of deviation both at distant and near fixation.While the scores of Proxy IXTQ were negatively correlated with the angle of deviation at distant and near fixation(r=-0.274,P=0.024;r=-0.325,P=0.007).The scores of Parent IXTQ were negatively correlated with the angle of deviation at distant and near fixation(r=-0.314,P=0.007;r=-0.251,P=0.039),the scores of social psychology dimension were negatively correlated with the angle of deviation at distant(r=-0.314,P=0.009),and the scores of surgical dimension were negatively correlated with the angle of deviation at distant and near fixation(r=-0.435,P=0.001;r=-0.420,P=0.001).Conclusions: 1.The QOL of IXT children and parents was lower than the normal children and parents,the greatest concern for children with IXT was the visual function,items related to social and psychological were of least concern.The concerns of parents were vision function,social psychology and surgical.2.The QOL of children with IXT was not correlated to the deviation angle.However,the QOL of parents tends to be worse with large angle of deviation,mainly concerned about whether surgery was required.3.It is recommended to routinely assess the QOL of IXT children and parents using the IXTQ in order to guide individual clinical treatment.