Pattern of Refractive Errors in Association with Strabismus Among Paediatric Patients (6-18 Years) Attending Ophthalmology Outdoors in BSMMU Hospital, Bangladesh

Background: Strabismus, a common ocular disorder among children, often coexists with refractive errors. Understanding the pattern of refractive errors in pediatric patients with Strabismus is crucial for effective clinical management. Since depth perception and binocular vision develop during the first six years, early detection and correction of refractive errors are essential to appropriate care. Methods: A hospital-based, retrospective cross-sectional association study was conducted among 235 pediatric patients attending BSMMU (Jan 2021 - Dec 2022), considering demographic characteristics and strabismus type, pre-treatment and post-treatment refractive errors. Analysis was implemented with SPSS v23, and p≤0.05 was considered statistically significant. Results: In this study (n=235), the mean age was 12.49±3.51 years. Refractive errors were myopia (25.5%), astigmatism (53.2%), hypermetropia (9.4%), and combined >10%. Strabismus was reported in 21.7% (31.4% esotropia, 68.6% exotropia). Myopia was higher in 12-16 years, and hypermetropia and astigmatism in 6-11 years (p<0.001). Girls had a higher prevalence of Strabismus, and boys had a higher prevalence of myopia and astigmatism. Hypermetropia showed a statistically significant association with the presence of strabismus (OR 2.8, p = 0.026), whereas myopia was less frequently observed among children with strabismus (OR = 0.39, p = 0.033). Conclusion: Nearly one-fourth of children with Strabismus were associated with refractive errors; astigmatism was the most frequently observed refractive error among children with strabismus. Regular screening, early interventions, and a holistic approach—including affordable care, parental awareness, parental education, and psychosocial support- are the key to better children's visual, educational, and social development.