Six year old children with strabismus (visible squint) are much less likely to be invited to birthday parties than other children of the same age, says a study published in the British Journal of Ophthalmology. Study authors say that children with a squint should undergo corrective surgery before they are six years old – the age when discrimination seems to start.
The researchers digitally altered photos of 6 children from 6 identical twin pairs to create inward and outward types of visible squint (strabismus) to compare against normally aligned eyes.
118 children aged from 3 to 12 were asked to select which of the identical twins they would invite to their birthday party. The children in the photographs were either eye clinic patients or siblings of the patients.
They were asked to select four times, so that they had a chance of choosing faces of up to four children with strabismus (a squint). An average of two children with a squint would have been selected if squints made no difference to the choice.
The authors reported that several factors, such as gender, what color top they were wearing, or the type of squint made no difference to the likelihood of selection.
Children under the age of 6 years did not make any distinction between a twin with a squint and one without a squint.
However, children aged six years or more were much less likely to choose children with a visible squint.
48 of the children who were choosing were aged from 6 to 8:
- 18 of them did not chose one single child with a squint
- 17 of them selected a child with a squint just once
- 11 of them selected a child with a squint twice
- 2 of them selected a child with a squint three times
- None of them selected a child with a squint four times
31 of the children who were choosing were aged between 4 and 6 years:
- 1 of them did not select one single child with a squint
- 21 of them selected a child with a squint once or twice
- 9 of them selected a child with a squint three or four times
When the selecting, the children were asked whether they had noticed anything particular about the twins:
- 19% of the 4 to 6 year olds mentioned eye alignment
- 39% of the 4 to 6 year olds mentioned eye alignment after being asked to focus on the eyes in the photographs
- 48% of the 6 to 8 year olds mentioned eye alignment
- 77% of the 6 to 8 year olds mentioned eye alignment after being asked to focus on the eyes in the photographs
The researchers say that a squint during childhood can have a long-term impact on the patient concerned and that “visible differences in general have a negative impact on how children are perceived by peers.”
The authors concluded:
Our results show that schoolchildren with strabismus seem less likely to be accepted by their peers, so corrective surgery for strabismus should be performed before the age of 6 years, when negative social implications may arise.
“Strabismus and discrimination in children: are children with strabismus invited to fewer birthday parties”
Stefania Margherita Mojon-Azzi, Andrea Kunz, Daniel Stephane Mojon
Online First Br J Ophthalmol 2010; doi 10.1136/bjo.2010.185793
Written by Christian Nordqvist