Knowledge and attitude towards strabismus among parents of Saudi children with strabismus

Sultan Alzuhairy, Elaf Saleh Alabdulrazaq, Ibtehaj Mohammed Alharbi, Dora Hammad Alharkan


Background: For early detection and timely management of strabismus in children, parent’s cooperation is essential. It depends upon their level of awareness. The objective was to describe the determinants and the level of knowledge and attitude towards strabismus among parents of children with strabismus in Saudi Arabia.

Methods: This cross-sectional study was conducted in 2018 at a hospital in Qaseem, Saudi Arabia. Consented parents of children with strabismus presenting to Qaseem University eye clinic were interviewed. Data were anonymously collected on participant demographics and the child’s strabismus. The survey interview consisted of 8 questions related to signs, symptoms, and management of strabismus. Three questions related to the attitude towards strabismus among parents/caregivers. Two separate questions queried the source of knowledge and possible barriers, respectively.

Results: Each parent of 81 children was interviewed. An excellent level of knowledge of strabismus was noted for 41 participants (50.6% at 95%CI 39.7-61.5). A positive attitude towards strabismus was noted in 57 participants (70.4% at 95% CI 60.4-80.3). No history of surgery was statistically associated to an excellent level of knowledge (P<0.001). Gender (P=0.7), age (P=0.7), father’s education (P=0.3), mother’s education (P=0.5), type of strabismus (P=0.8) were not associated with the level of knowledge. High cost (43.2%) and false beliefs (53.1%) were the main barriers to medical consultations.

Conclusions: Parents of children with strabismus presenting to a tertiary care eye hospital had good knowledge about the signs, symptoms and management of strabismus. Addressing barriers perceived by parents may improve early presentation rates of children with strabismus allowing timely management.


Attitude, Barriers, Childhood blindness, Knowledge, Strabismus

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Koo EB, Gilbert AL, Vanderveen DK. Treatment of amblyopia and amblyopia risk factors based on current evidence. In: Seminars in ophthalmology. Taylor and Francis; 2017:1-7.

Granet DB, Khayali S. Amblyopia and strabismus. Pedia Ann. 2011;40(2):89-94.

American Academy of Ophthalmology. Preferred pattern of practice. Strabismus summary, 2017. Available at: Accessed 21 October 2018.

Campbell LR, Charney E. Factors associated with delay in diagnosis of childhood amblyopia. Pediatrics. 1991;87(2):178-85.

Teutsch SM, Margaret A, McCoy R. National Academies of Sciences, Engineering and Medicine. Making eye health a population health imperative: vision for tomorrow., Washington, USA: National Academies Press; 2017:452.

Singh A, Rana V, Patyal S, Kumar S, Mishra SK, Sharma VK. To assess knowledge and attitude of parents toward children suffering from strabismus in Indian subcontinent. Ind J Ophthalmol. 2017;65(7):603.

Al-Rowaily MA. Prevalence of refractive errors among pre-school children at king abdulaziz medical city, Riyadh, Saudi Arabia. Saudi J Ophthalmol. 2010;24(2):45-8.

Aldebasi YH. Prevalence of amblyopia in primary school children in Qassim province, kingdom of Saudi Arabia. Middle East African J Ophthalmol. 2015;22(1):86.

Ministry of Health, Saudi Arabia. Demographic indicators in Annual Statistical Book; 2017:27. Available at: Accessed on 22 October 2018.

Dean AG, Sullivan KM, Soe MM. Open source epidemiologic statistics for public health, version. Available at: Accessed 22 October 2018.

Al-Jarf R. The impact of English as an international language (EIL) upon Arabic in Saudi Arabia. Asian EFL J. 2008;10(4):193-210.

Etelson D, Brand DA, Patrick PA, Shirali A. Childhood obesity: do parents recognize this health risk?. Obes Res. 2003;11(11):1362-8.

Soliman SE, ElManhaly M, Dimaras H. Knowledge of genetics in familial retinoblastoma. Ophthalmic Genetics. 2017;38(3):226-32.

Tates K, Elbers E, Meeuwesen L, Bensing J. Doctor-parent-child relationships: a ‘pas de trois’. Patient Edu Counseling. 2002;48(1):5-14.

Ansons AM, Davis H. Nonsurgical management of ocular motility disorders in ‘diagnosis and management of ocular motility disorders’. John Wiley Sons; 2008:143-162.

Nichter M. Global. Health: why cultural perceptions, social representations, and biopolitics matter. Uni Arizona; 2008: 65-70.

Deeks A, Lombard C, Michelmore J, Teede H. The effects of gender and age on health related behaviors. BMC Public Health. 2009;9(1):213.

Bahakim HM. Muslim parents' perception of and attitude towards cancer. Ann Tropical Paediatrics. 1987;7(1):22-6.

Morahan-Martin JM. How internet users find, evaluate, and use online health information: a cross-cultural review. Cyberpsychology Behavior. 2004;7(5):497-510.

Walston S, Al-Harbi Y, Al-Omar B. The changing face of healthcare in Saudi Arabia. Ann Saudi Med. 2008;28(4):243-50.

Cooper J, Cooper R. All about strabismus. Strabismus. Org, 2006. Accessed 10 December 2018.