Researchers in Turkey assessed the psychological effects of preoperative primary eye position and surgical correction of strabismus in adolescent patients—and found one more reason to consider referring patients for surgery: improved mental health.

The observational and prospective study divided 83 adolescent patients with exotropia into two groups: patients with preoperative manifest exotropia (manifest exotropia group) and patients with intermittent exotropia that had orthophoria with overcorrecting minus lenses and recently increased frequency of manifest phase (latent deviation group).

Researchers scored each patient with several questionnaires before and one year after strabismus surgery, including the Turkish version of the Social Appearance Anxiety Scale (SAAS), depression subscale of Hospital Anxiety and Depression Scale (HAD-D) Brief Fear of Negative Evaluation Scale (BFNE), state anxiety subscale of State-Trait Anxiety Inventory (STAI-S) and trait anxiety subscale of State-Trait Anxiety Inventory (STAI-T).

Before surgery, the manifest exotropia group had significantly higher mean preoperative scores in all scales than the latent deviation group. Strabismus surgical correction improved outcomes in all five scales for the manifest exotropia group. However, only STAI-S and STAI-T scores significantly improved in the latent deviation group post-surgery. The mean postoperative scores of all scales did not significantly differ between the two groups.

Researchers conclude that eye deviation from strabismus can be a strong indicator of psychological distress.