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There is a general consensus that individuals with conspicuous strabismus are perceived more negatively with respect to physical appearance, personality and capability. Such social biases can potentially lead to social alienation and negative psychosocial development, particularly when experienced at a young age. This study aims to explore young children's perception of peers with noticeable exotropia.

128 children, 5–6 years old, took part in this cross-sectional within-group study. The sample viewed four paired images of peers with orthotropia and exotropia, and chose the image they LIKED and the image they would SHARE their favourite toy with. All images were created using digital morphing technique.

Single proportion tests showed that a significantly greater proportion of the sample chose the orthotropic images as the ones they like (z=5.74, p<0.001) and the ones they would share …