Abstract

Introduction: This study aimed to investigate the impact of strabismus on self-concept in school-aged children and to evaluate changes in self-concept six months after strabismus surgery. Subjects and Methods: This prospective multicenter study included children aged 7–15 years who underwent strabismus surgery at the Strabismus Units of Beyoğlu Eye Research and Training Hospital and Marmara University Hospital between December 2023 and June 2024. Self-concept was assessed using the validated Turkish version of the Piers–Harris Self-Concept Scale (PHSCS) before surgery and six months postoperatively. Only patients with complete preoperative and postoperative assessments were included in the final paired analysis. Results: A total of 116 children were enrolled, of whom 84 (42 boys and 42 girls; mean age, 10.9 ± 2.2 years) had complete data and were included in the final analysis. Overall, 73.6% of participants reported that strabismus affected their daily lives, with 77.4% describing this impact as negative. Furthermore, 65.5% stated that strabismus affected their relationships with friends. Following surgery, 80.9% of participants were satisfied with the surgical outcome, and 85.7% would recommend the procedure to others. The mean total PHSCS score increased from 58.2 ± 10.4 preoperatively to 59.0 ± 10.1 postoperatively, although this difference did not reach statistical significance (p = 0.05). In contrast, the Physical Appearance and Attributes subscale showed a significant improvement after surgery (8.3 ± 1.6 vs. 8.9 ± 1.9, p < 0.005), whereas no significant changes were observed in the remaining subscales. Conclusions: School-aged children with strabismus may experience psychosocial challenges related to their condition, particularly in their interactions with peers. Although overall self-concept remained largely unchanged, self-perception of physical appearance improved following strabismus surgery. These findings suggest that surgical correction may contribute to improvements in selected aspects of self-concept; however, larger prospective controlled studies are needed to confirm these observations.

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