Children whose eyes are misaligned and point outward are at significantly increased risk of developing mental illness by early adulthood, according to findings of a Mayo Clinic study published this month in Pediatrics, the official journal of the American Academy of Pediatrics.
The retrospective study examined the medical records of 407 patients with strabismus and compared them with those of children matched for age and sex but with normal eye alignment. Children with eyes that diverged (exotropia) were three times more likely to develop a psychiatric disorder than were the control subjects, while those with inward deviating eyes (esotropia) showed no increase in the incidence of mental illnesses.
Brian Mohney, M.D., the Mayo Clinic pediatric ophthalmologist who led the study, describes the research findings and the observation that caused the study to be conducted:
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6 Comments
I would be curious to see what the actual numbers were. The article said “children with eyes that diverged (exotropia) were three times more likely to develop a psychiatric disorder than were the control subjects”. So 4 times as many children with exotropia had a psychiatric disorder than those without? Or was it really three times AS likely?
I am functionally a one-eyed person with a spare eye. I had surgery to remedy the outward symptoms of exotropia- on both eyes, one around age 5 and the other around age 11. What remains unchanged nearly 50 years later is the complete absence of stereo vision and normal depth perception; even though my eyes are aligned, the corresponding visual centers in my brain missed their only opportunity to develop connections. If I look through binoculars or a stereo microscope, I am aware of seeing two separate images. In ordinary life, I live in a flat world.
For photography, this can be an advantage of sorts- but for just walking around, there are situations when it is quite unnerving to be forced to navigate three dimensions with a visual system that handles only two.
Technology offers some vocabulary to help explain how it is to have a streaming video buffer overrun happen in my brain- the picture hangs and lags, but the sound continues smoothly on. If I’m skiing, I know to simply drop onto the snow: the tree that I thought was over THERE may possibly be right HERE. To a conventionally-sighted onlooker, this probably looks awfully odd…
Esotropia would not so preclude development of optic-center connections that allow stereo vision and a full experience of the three dimensional world.
What I wonder about folks with exotropia: is the documented greater risk of psychiatric illness related more to an inner disconnect (eye and brain), or an outer one (world and brain)? -is surgical repair now followed up with support for adapting to a very different visual experience of the world?
Thanks for your comments. If you want to see the actual numbers, they are linked to the journal article in the first paragraph of the story, but here is the link also:
http://pediatrics.aappublications.org/cgi/content/full/122/5/1033
This is an interesting study that has the potential to negatively affect the lives of thousands of adults or children. Taken out of context strabismus could end up being used as a differential hiring criteria between to superficially qualified candidates. The bias potential is already there within the the society.
Further research is needed on the neurological significance referenced in the previous description of connectivity. However, more importantsly to avoid the social stigma of this research it is even more important that children recieve immediate and aggressive care for the cosmetic value.
This is very interesting. My husband had surgery for a “lazy eye” when he was 26. I don’t know if a lazy eye and strabismus are the same thing, but it kind of made me go “hmmm…”, as he is now bipolar.
I am going thru a time with a 14 year old – whom was born preemie and now has developed Intermittent exotropia – so say say mental illness – well if you only knew what my child has gone thru when nobody understands -and in school all he gets is torment by teachers and labelled – teased by classmatess, being tripped sticking a foot out becasue he cant see , stealing his glasses from him – what do you think this would do to you as a child, cant play sports being you cannot see the ball coming at you!
Mental illness – interesting – now he has another battle to fight – may as well give up being your labelled in all directions!