Center of Biomedical Research Excellence in Cell Biology, University of Nevada, Reno School of Medicine, Reno, Nevada, USA.
School of Public Health, University of Nevada, Reno, Nevada, USA.
J Glob Health. 2023 Sep 1;13:04085. doi: 10.7189/jogh.13.04085.
Strabismus is a misalignment of the visual axis that affects 2-3% of the population and can lead to loss of binocular vision. It is currently controversial whether there is a gender difference in the most common form of visual misalignment: horizontal strabismus. Some studies claimed that more females than males have an outward deviation (exotropia), while others concluded that there is no significant gender difference. No previous work has systematically explored gender differences in horizontal strabismus or has compared the results of population-based studies with those of clinic-based studies.
We conducted a systematic review and meta-analysis of studies reporting the prevalence of horizontal strabismus. We included 73 population-based studies and compared their disclosed gender population with that in 141 comparable clinical-based studies. We analysed the data according to gender, strabismus type (esotropia, exotropia), and geographic region/ethnicity.
Summary statistics showed a nearly identical prevalence of horizontal strabismus (2.558% for males, 2.582% for females), esotropia (1.386% males vs. 1.377% females), and of exotropia (1.035% males vs. 1.043% females). Meta-analysis results showed that these differences between males and females were not statistically significant (odds ratio (OR) = 1.01; 95% confidence interval (CI) = 0.97-1.10), but that females were significantly more frequent (by 7.50%) in clinic-based studies than males, with 5.00% more females for esotropia, and 12.20% more females for exotropia when adjusted for the population's sex ratio. The extent of the female gender bias differed between geographic regions/societies, with Asians having the lowest bias towards females and Latin American countries having the strongest bias.
Males and females have the same prevalence of horizontal strabismus, including exotropia. Females with strabismus seek health care or are brought to clinics significantly more often than males. This is an example of gender bias in health care in favour of females rather than males, apparently because parents - erroneously fearing only cosmetic consequences - are more concerned about strabismus in their daughters than their sons. Societal attitudes towards females, as well as economic factors (insurance status), appear to be relevant factors that determine the magnitude of the gender bias in horizontal strabismus.
斜视是一种眼球视轴的错位，影响了 2-3%的人群，并可能导致双眼视觉丧失。目前，关于最常见的视觉错位形式（水平斜视）是否存在性别差异存在争议。一些研究声称，女性中出现外斜视（外斜视）的比例高于男性，而另一些研究则得出结论，性别差异不显著。以前没有研究系统地探讨水平斜视中的性别差异，也没有将基于人群的研究结果与基于临床的研究结果进行比较。
我们对报告水平斜视患病率的研究进行了系统综述和荟萃分析。我们纳入了 73 项基于人群的研究，并将其报告的性别人群与 141 项基于临床的可比研究进行了比较。我们根据性别、斜视类型（内斜视、外斜视）和地理位置/种族进行了数据分析。
汇总统计数据显示，男性和女性的水平斜视患病率（男性 2.558%，女性 2.582%）、内斜视（男性 1.386%，女性 1.377%）和外斜视（男性 1.035%，女性 1.043%）几乎相同。荟萃分析结果表明，男性和女性之间的这些差异没有统计学意义（比值比（OR）=1.01；95%置信区间（CI）=0.97-1.10），但女性在基于临床的研究中比男性更常见，调整人口性别比例后，内斜视的女性多 5.00%，外斜视的女性多 12.20%。亚洲的性别偏见程度最低，而拉丁美洲国家的性别偏见程度最高。
男性和女性的水平斜视患病率相同，包括外斜视。有斜视的女性比男性更频繁地寻求医疗保健或被带到诊所。这是医疗保健中有利于女性而不是男性的性别偏见的一个例子，显然是因为父母错误地只担心美容后果，对外斜视比儿子更担心女儿。社会对女性的态度以及经济因素（保险状况）似乎是决定水平斜视性别偏见程度的相关因素。
