Nursing research provides new information on the impact of strabismus on adult quality of life

Strabismus is not only a physical misalignment of the eyes, but it can cause psychosocial harm and affect the quality of life. Clinical Teacher in Nursing at HUS, Doctoral Researcher Anna Mason studied what kind of negative psychosocial impact strabismus can have on adults.

In the first part of her work, Mason translated the health-related AS-20 quality of life questionnaire from English into Finnish, which was adopted by the HUS Strabismus Unit. In the questionnaire, the adult patient assesses the functional and psychosocial impacts of strabismus on their quality of life.

The results show that women feel that their functional quality of life is worse than men. In addition, the youngest respondents had a poorer self-image than older respondents. Patients with no diplopia reported lower psychosocial well-being than adults with diplopia.

"The questionnaire instrument can be used to objectively measure the change in the quality of life reported by a strabismic patient, and this way, assess the effectiveness of the treatment, such as strabismus surgery. The questionnaire also helps professionals ask about psychosocial impact," Mason says.

Psychosocial effects of strabismus should be identified in healthcare

As part of her research, Mason interviewed strabismic adult patients who described the psychosocial harm they had suffered. Participants found social situations challenging and struggled with their mental well-being.

The psychosocial effects experienced by the patients may manifest themselves as avoiding eye contact during interaction, avoiding social situations and suffering from self-esteem problems. The patients said they had been bullied and stared at.

"Multiple patients would like to receive peer support and hope that professionals would ask more actively about psychosocial impact at the appointments. It is important that healthcare professionals recognise the effects of strabismus and provide the necessary support," Mason says.

Lessons learned from the establishment of a COVID-19 ward to the dissertation process

Already as a child, Mason knew she wanted to be a nurse. After graduating, she worked as a pediatric registered nurse, after which she moved to the UK for six years. She also occasionally worked at HUS Emergency Outpatient Clinic for Eye Diseases. After moving back to Finland, Mason returned to the Emergency Outpatient Clinic for Eye Diseases as the final stage of her Master’s studies. She developed an interest for a research career when she was completing her Master’s thesis. During her study leave, Mason also ended up as one of the founders of the first COVID-19 ward at the Surgical Hospital.

"It was one of the most difficult, but also the most significant experiences of my career. It taught me the courage to try something new and not to be afraid of failure. If something doesn't work, then let's try something else. The same principles apply to the dissertation process, as well. Rejections and criticism are part of the journey. Having courage to push forward is the most important thing," Mason says.

Immense research potential in clinical nursing

Mason encourages registered nurses to participate in clinical nursing studies. As a curious person, she feels that there is a great deal to study in clinical nursing.

"The effectiveness of nursing should be studied more than at present. There is little research on ophthalmological nursing, in particular, and even less on nursing related to children's and adolescent’s eye diseases. There would be plenty of opportunities in these areas to develop nursing through research."

Anna Mason's doctoral dissertation Health-Related Quality of Life in Finnish Strabismic Adults and Recommendations for Psychosocial Support was reviewed at the Faculty of Social Sciences of Tampere University on 14 February 2025.