Negative social reaction to strabismus in school children ages 8-12 years

Purpose To investigate children's willingness to sit next to a child with noticeable exotropia as a measure of social alienation. Methods This was a cross-sectional, mixed-design study. Children in primary grades 3-6 (8-12 years old) were asked to view 8 digitally modified images of exotropic or orthotropic children in classroom settings and rate their willingness to sit next to the child in each image. Results A total of 157 children participated. A 4 × 2 × 2 mixed-design analysis of variance revealed a significant main effect for primary level (F [3, 151] = 4.06, P = .01, partial η2 = .08) and for image type, exotropic versus orthotropic, (F [1, 151] = 108.45, P = .00, partial η2 = .42). The results of the main effects were qualified by a significant primary level X image type interaction (F [3, 151] = 4.00, P = .01, partial η2 = .08). Children were less willing to sit next to a person with noticeable exotropia. Although this phenomenon was consistent across all primary levels, the magnitude of the effect diminished in strength for children in higher primary levels. Conclusions This study further strengthens existing evidence for strabismus-related prejudice that suggests that children with noticeable strabismus may be subjected to social alienation by other children.