A recent study revealed that strabismus surgery may decrease injury risk in pediatric patients. Unintentional injury is a leading risk of death in children, and impaired motor skills and depth perception brought on by the disease could make this population even more susceptible. Previous research has shown a 13% higher risk of injury for children with strabismus patients compared to those with healthy eyes; for specific form esotropia, injury risk is even higher at 17%. Children who undergo surgery to correct strabismus could face a 15% decrease in risk of physical injury, as shown in this study based on four years of follow-up. 

Researchers reviewed data from included in the OptumLabs Data Warehouse. Esotropia was the most common diagnosis, followed by exotropia, strabismus not otherwise specified and hypertropia. Surgery had been performed in 26,459 (7.7%) of the subjects. Records and injury claims from those who underwent surgery were compared to those who did not. 

Of the patients who didn’t undergo surgery, 29.8% had a diagnosed injury after the first strabismus insurance claim, but for those who had surgery, just 21.9% were diagnosed with injuries after. Exotropic patients experienced the most decreased risk of injury postoperatively, likely due to a better chance of maintaining or improving binocular vision. 

“The adjusted hazard ratio for injuries was 0.85 for the risk of any injuries for strabismus surgery compared with no surgery,” the researchers explained. “A Kaplan Meier plot revealed a sustained benefit from strabismus surgery in preventing injury over the duration of the follow-up.” 

The authors of the study attribute this reduced injury risk after surgery to improvements in gross motor development, postural stability, gait safety and balance control. Younger age of strabismus onset and subnormal stereoacuity are both associated with poorer motor skills, as observed in a former study. Those previous findings, along with this study’s results, demonstrate that strabismus affects most areas of motor development and that these effects may be more detrimental to children of younger ages. Luckily, this data suggests that surgery could help restrengthen motor skills and improve mobility.

Limitations of this study include the inability to determine the severity and subtype of each child’s strabismus and physical injury. Outside factors were also not accounted for, such as activity level, adult supervision and level of risk-taking behavior for each child. However, based on data, children who receive strabismus surgery face a lower risk of injury and better overall health. 

Pineles SL, Repka MX, Yu F, et al. Strabismus surgery decreases the risk of injuries in pediatric patients in the OptumLabs data warehouse. Am J of Ophthal. July 5, 2021. Epub ahead of print.