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Influence of intermittent exotropia surgery on general health-related quality of life: different perception by children and parents



To assess the general health-related quality of life (QOL) in children with intermittent exotropia (IXT) before and 3 months after surgery, by interviewing individual patients and their parents.

Study design

Prospective, interventional case series.


Twenty-one patients undergoing IXT surgery and their parents were included. Using the Pediatric Quality of Life Inventory (PedsQL), children and parents were separately questioned about QOL of patients.


The mean patients’ age was 8.6 ± 3.2 years (SD), with range of 5–16 years. The children responded that all PedsQL scores were significantly improved by surgery, and the highest improvement was observed in the school subscale score. When the parents rated the children’s QOL, significant improvements were limited to 3 out of 7 subscales, including the emotional, psychosocial health summary, and total scores. The improvements in the PedsQL score were not correlated with age, size of deviation changes following surgery, nor the improvement in binocular vision.


The general health-related QOL significantly improved by surgery in pediatric patients with IXT, while the improvement was considerably underestimated by the parents. The children reported the greatest improvement in the school functioning subscale, whereas parents failed to discern this improvement. The discrepancy in children’ and parents’ views can be an important factor when considering indication of corrective surgery and evaluating surgical outcomes.

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Correspondence to Tetsuro Oshika.

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Y. Morita, None; T. Hiraoka, None; T. Oshika, None.

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Corresponding Author: Tetsuro Oshika

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Morita, Y., Hiraoka, T. & Oshika, T. Influence of intermittent exotropia surgery on general health-related quality of life: different perception by children and parents. Jpn J Ophthalmol 65, 326–330 (2021).

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  • Intermittent exotropia
  • Parents
  • Pediatric patients
  • Quality of life
  • Strabismus