the parents of children with a squint and amblyopia , having an access to internet at home and/or office and who would access the internet on daily basis were given a questionnaire [ table 1 ] . only those parents who had not visited an ophthalmologist prior to this visit and who had not done an internet search relevant to the study were included . the parents were first informed that the child had a significant strabismus and required further evaluation three days later . the child was prescribed atropine eye ointment for 3 days for cycloplegic refraction as was the routine protocol of the clinic . questionnaire used in the study the parents were given a questionnaire and explained the purpose of this study . completely filled questionnaire was returned on the follow - up visit that was scheduled within a week . each answer was scored ( 0 for no / wrong answer and + 1 for the correct answer ) , and cumulative scores were analyzed . paired t - test was performed to compare the total score before and after the google search . p < 0.05 was considered as statistically significant . for 80% power , 5% level of significance , 3.0 standard deviation and 20% effect size we needed n = ( z1/2 z1 ) sd / d that is , 18 patients . for 80% power , 5% level of significance , 3.0 standard deviation and 20% effect size we needed n = ( z1/2 z1 ) sd / d that is , 18 patients . mean total score before google search was 3.8 out of a maximum 8 ( standard deviation 1.9 , range 07 ) . about 76% parents were not aware of the potential defects that occur due to a squint or aware of the correct success rates of the squint surgeries [ fig . 1 ] . highest positive impact of google search was seen on question 3 ( 47% ) and 2 ( 39% ) . in 1 patient , negative impact of google search was seen on question 5 [ fig . 2 ] . the number of correct responses to the questionnaire before and after  google  search the percentage improvement in the correctness of the responses for each question google search engine is frequently accessed by the patients coming to our clinics for obtaining relevant medical information . many patients would have either visited multiple websites prior to meeting us or browse through them after we have informed them about the medical diagnosis . despite multiple studies reporting the lack of accuracy and reliability of internet for obtaining the information the medical fraternity needs to provide unbiased and scientific guidelines to their patients on what to rely and what not to rely when using the internet . in this study , we found that google search had a positive impact on the knowledge of the patients regarding the disease . however , the information was incomplete and many times biased with regards to the treatment protocols and outcomes . the study demonstrated that the internet was a reliable source of information for the etiopathogenesis and the defects due to the disease . that information remained unbiased , was obtained from the books and authentic research papers , and there were no commercial interests in that information . however , the information regarding the treatment was controversial and had a major commercial angle to it when the contents of the websites were evaluated by the co - author from the first 10 websites on  google  search engine for the keywords  squint  using table 2 . the scoring system and the results of the evaluation of the top 10 of the  google  search engine we encourage the patients to use internet to know more about their disease albeit with the knowledge that the information on the etiopathogenesis and the disease associated handicap would be reliable . the information about the treatment could be incomplete , frequently written by nonexperts and with the commercial objectives .
internet is used by many patients to obtain relevant medical information . 
 we assessed the impact of  google  search on the knowledge of the parents whose ward suffered from squint . 
 in 21 consecutive patients , the  google  search improved the mean score of the correct answers from 47% to 62% . 
 we found that 
 google 
 search was useful and reliable source of information for the patients with regards to the disease etiopathogenesis and the problems caused by the disease . 
 the internet - based information , however , was incomplete and not reliable with regards to the disease treatment .