During the 2024 Olympic Games, gymnast Stephen Nedoroscik drew attention not only for his remarkable athletic achievements but also for the visual conditions he lives with—strabismus and coloboma. His presence on such a global stage helped bring awareness to conditions that often remain in the shadows, yet affect millions worldwide. Though Nedoroscik’s story is inspiring, adult strabismus is much more than a visual anomaly; it has deep psychological and social implications.
Adult Strabismus: More Than Meets the Eye
Strabismus, commonly referred to as crossed eyes, affects 2% to 3% of the U.S. population. It occurs when the eyes are not aligned in the same direction, which can lead to problems such as double vision, difficulty with depth perception, and even amblyopia, or permanent vision loss, if left untreated. While strabismus is often diagnosed in childhood, it can also develop later in life due to factors such as neurological issues, trauma, or untreated childhood cases.
The condition is more than just a physical misalignment of the eyes. For many adults, strabismus can be a source of ongoing frustration, impacting their ability to navigate the world visually. And beyond the obvious vision challenges, there is a growing body of evidence that suggests adult strabismus has significant psychological effects as well.
The Psychological Burden of Adult Strabismus
Recent research published in JAMA Ophthalmology has shed light on the strong association between adult strabismus and mental health conditions. The study, which analysed data from the National Institutes of Health’s All of Us Research Program, found that adults with strabismus were two to three times more likely to experience mental health conditions such as anxiety, depression, substance use disorders, bipolar disorder, and even schizophrenia compared to those without the condition.
This association points to the profound psychological burden that individuals with strabismus may face. It is well-documented that visible differences like strabismus can negatively impact self-esteem and social interactions, leading to isolation and, in some cases, mental health issues. The impact can be especially severe for those who developed it later in life, as they may struggle with the social and psychological adjustments required to cope with the condition.
Understanding the Data
The study involving 3,646 adults strabismus highlights a critical aspect of care that often goes overlooked. Beyond managing the physical symptoms of the condition, there is a need for addressing the mental health challenges that accompany strabismus. The research found that anxiety and depression were especially prevalent, affecting roughly one-third of adults with strabismus, a stark contrast to the control group without strabismus.
These findings underscore the need for comprehensive care that considers both the physical and emotional well-being of individuals with strabismus. While ophthalmological treatment typically focuses on aligning the eyes through non-surgical methods such as prism glasses or surgical interventions, there is a growing recognition that mental health support should be part of the overall treatment plan.
Clinical Approaches and Guidelines
The American Academy of Ophthalmology’s (AAO) 2024 Preferred Practice Pattern (PPP®) for adult strabismus offers guidance on managing the condition. Treatment options vary based on the severity of strabismus and the specific needs of the individual. Non-surgical methods, such as prism glasses or eye exercises, may be sufficient for some, while others may require invasive surgery to adjust the position of the eye muscles.
It is important to note that even after treatment, some adults may continue to experience intermittent eye misalignment, particularly when they are fatigued or not actively concentrating on aligning their eyes. For these individuals, ongoing care and follow-up with an eye specialist are crucial to ensuring the best possible outcomes.
In addition to physical treatments, the AAO PPP® emphasises the importance of a multidisciplinary approach to care. This includes integrating mental health professionals into the care team to help individuals manage the emotional and psychological challenges associated with strabismus. Addressing the mental health aspects of the condition is particularly important for adults who may feel isolated or self-conscious about their appearance.
A Comprehensive Approach to Strabismus Care
Strabismus is a condition that extends far beyond the alignment of the eyes. Its effects can be deeply felt in the emotional and psychological lives of those who live with it, as seen in the research connecting strabismus with mental health conditions. By approaching strabismus care holistically, integrating both physical and psychological treatment, individuals with the condition can achieve a higher quality of life.
Awareness and early intervention are key to preventing long-term complications from strabismus, both physical and psychological. Stories like that of Stephen Nedoroscik highlight the resilience of those living with strabismus and bring awareness to a condition that requires comprehensive care and understanding from both medical professionals and society at large.
References
- American Journal of Managed Care (AJMC). (2024). Strabismus Associated With Mental Health Conditions in Adults. Accessed August, 2024. Available at: https://www.ajmc.com/view/strabismus-associated-with-mental-health-conditions-in-adults
- Dagi LR, Velez FG, Holmes JM, et al. Adult Strabismus Preferred Practice Pattern®. Ophthalmology. 2024;131(4):P306-P403. doi:10.1016/j.ophtha.2023.12.040
- Jin K, Aboobakar IF, Whitman MC, Oke I. Mental Health Conditions Associated With Strabismus in a Diverse Cohort of US Adults. JAMA Ophthalmol. 2024;142(5):472-475. doi:10.1001/jamaophthalmol.2024.0540
- Ophthalmology Times. (2024). Stephen Nedoroscik Brings Awareness to Strabismus, Coloboma at the 2024 Olympic Games. Accessed August, 2024. Available at: https://www.ophthalmologytimes.com/view/stephen-nedoroscik-brings-awareness-to-strabismus-coloboma-at-the-2024-olympic-games
About Docquity
If you need more confidence and insights to boost careers in healthcare, expanding the network to other healthcare professionals to practice peer-to-peer learning might be the answer. One way to do it is by joining a social platform for healthcare professionals, such as Docquity.
Docquity is an AI-based state-of-the-art private & secure continual learning network of verified doctors, bringing you real-time knowledge from thousands of doctors worldwide. Today, Docquity has over 400,000 doctors spread across six countries in Asia.
Meet experts and trusted peers across Asia where you can safely discuss clinical cases, get up-to-date insights from webinars and research journals, and earn CME/CPD credits through certified courses from Docquity Academy. All with the ease of a mobile app available on Android & iOS platforms!
