Discrepancies between parental reports and clinical diagnoses of strabismus in Korean children

Purpose: To compare the accuracy of parental observation of strabismus with clinical evaluation in Korean children. Methods: The medical records of 228 children <15 years of age who visited the pediatric strabismus clinic from 2002 to 2007 and whose parents reported a horizontal deviation were retrospectively reviewed. We compared subjective parent-reported direction of ocular deviation with the objective results after clinical evaluation. Results: The mean age of the 228 children was 3.9 ± 3.0 years. Of these, 178 children (78%) were diagnosed with strabismus; 50 (22%), with orthotropia. The overall concordance rate was 67% (152/228). The concordance rate was lower for parents reporting inward deviation of the eye (P < 0.001), younger age group at presentation (P = 0.004), experienced onset of ocular deviation at younger age group (P = 0.001), and had fewer diopters of deviation (P < 0.001). Patient sex, family history of strabismus, observed frequency of deviation, and laterality of deviated eye did not show statistical differences in concordance rates (all P values >0.05). Conclusions: Parental observation correlated with clinical assessment two-thirds of the time. Exotropia was more reliably detected by the parents than esotropia.