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

Hera Lukman, John E Kiat, Asha Ganesan, Wei Ling Chua, Kheng Leik Khor, Yee Fong Choong

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


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 η(2) = .08) and for image type, exotropic versus orthotropic, (F [1, 151] = 108.45, P = .00, partial η(2) = .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 η(2) = .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.

Original languageEnglish
Article number10.1016/j.jaapos.2011.01.158
Pages (from-to)238-40
Number of pages3
JournalJ Am. Assoc. for Pediatric Opthalmology and Strabismus
Issue number3
Publication statusPublished - 11 Jun 2011
Externally publishedYes


  • Child
  • Cross-Sectional Studies
  • Exotropia
  • Humans
  • Interpersonal Relations
  • Prejudice
  • Social Alienation
  • Social Behavior


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