A Retrospective Study on the Eye-Related Quality of Life, Functional Vision, and Their Determinants Among Children Following Congenital and Developmental Cataracts Surgery and Its Impact on Their Families Using the PedEyeQ

Abstract

ObjectivesTo evaluate the eye-related quality of life (ER-QOL), functional vision, and their determinants in children following congenital and developmental cataract surgery, as the impact on their families, using the Pediatric Eye Questionnaire (PedEyeQ).Materials and MethodsThis was a retrospective cross-sectional study involving 107 children (aged 0–11 years) with congenital and developmental cataracts who had undergone surgery, as well as 59 visually healthy controls (aged 0–11 years). One parent for each child completed either the Proxy 0–4 PedEyeQ, the Proxy 5–11 PedEyeQ, or the Parent PedEyeQ, depending on their child's age. Mann-Whitney U and Kruskal-Wallis tests were then conducted to compare the differences between groups and to analyze their determinants.ResultsPedEyeQ scores were found to be lower in postoperative children with congenital and developmental cataracts compared with the control group across all study domains. The PedEyeQ Proxy 0 to 4 years' greatest mean difference was 27 points worse in the Functional Vision domain (95% CI −34 to −19; p < 0.001). We also found that the occurrence of nystagmus (p < 0.005) and strabismus (p < 0.005) were the major factors affecting participants' functional vision. The PedEyeQ Proxy 5 to 11 years' greatest mean difference was 23 points worse in this same domain (95% CI −30 to −15; p < 0.001), with nystagmus (p < 0.05) being the main determinant herein. Parent PedEyeQ 0 to 4 years' greatest difference was 46 points worse on the Worry about their Child's Eye Condition domain (95% CI −57 to −36; p < 0.001). Similarly, parents of children with ophthalmologic abnormalities, including nystagmus (p < 0.001) and strabismus (p < 0.05), were significantly more worried about their children's eye condition. Parent PedEyeQ 5 to 11 years' greatest difference was also found to be 30 points worse on the Worry about their Child's Eye Condition domain (95% CI −43 to −17; p < 0.005).ConclusionsChildren who have undergone congenital and developmental cataract surgery experience a lower quality of life and reduced functional vision. Their families are also significantly and adversely affected herein. Thus, more attention is needed on these groups, with more focused measures being administered to both children and their families.

Patching in Children With Unilateral Congenital Cataract and Child Functioning and Parenting Stress

“…−0.2 (−2.0 to 1.5) −0.8 (−2.6 to 1. blyopia also failed to identify a negative association of patching with child and family functioning. 31 Additionally, it is possible that the visual condition itself, 33 the lack of stereopsis, and/or the cosmetic effect of these conditions are more strongly associated with health-related quality of life than patching. There is some evidence for this in our own data given that, among children patched at least 120 minutes per day, parenting stress scores were higher and reported child behavior problems were more prevalent among children with poorer vision in the treated eye than in those with better vision, even after adjusting for the average amount of patching (eTable 2 in Supplement 1).…”

Impact of Vision Impairment and Ocular Morbidity and Their Treatment on Quality of Life in Children: A Systematic Review

“…Eight observational studies concerning vision impairment were not included in the meta-analysis because of the lack of a composite outcome score (n ¼ 2), 19,23 proxy report of outcome (n ¼ 1), 6 inability to separate myopia from other causes of refractive error (n ¼ 1), 28 and research questions outside the scope of the metaanalysis (n ¼ 4). 24,27,29,30 Children with vision impairment had 35.6% lower QoL scores than children with normal vision, even after receiving comprehensive visual rehabilitation. 6 Children with congenital bilateral cataracts had lower scores for visionrelated QoL than unaffected control participants.…”

“…The most commonly used tools were the Intermittent Exotropia Questionnaire (n ¼ 12), 30,36,38,40,45e49,52,53,55 the Pediatric QoL Inventory (n ¼ 11), 7,18e21,26,29,33,34,42,51 and the 25-item National Eye Institute Visual Function Questionnaire (n ¼ 7). 21,22,28,31,32,37,44 Other questionnaires included the RAND Health Insurance Study questionnaire, 43,54 the Pediatric Eye Questionnaire, 24,27 the World Health Organization QoL Scale, 25 the QoL Impact of Refractive Correction, 59 the scale of QoL for children with congenital bilateral cataract, 58 a self-developed questionnaire to assess the impact of amblyopia treatment on health-related QoL, 56 the Children's Visual Function Questionnaire, 23 the generic KINDL-R questionnaire, 35,39 the LV Prasad Functional Vision Questionnaire, 57 and the Low Vision QoL Questionnaire. 6 Nine of these instruments were condition specific and 4 were general.…”

Comparison of Functional Vision and Eye‐Related Quality of Life between Myopic Children Treated with Orthokeratology and Single‐Vision Spectacles in Southern China

“…Moreover, it can be used to evaluate children and parents/legal guardians at the same time. Te PedEyeQ has been applied to and verifed in a wide range of pediatric eye diseases, such as strabismus, amblyopia, ametropia, cataract, and retinal diseases [17][18][19][20][21][22][23][24][25], but has not been used in a comparative study of OK contact lenses and SVS worn by myopic children. Tus, this study used the PedEyeQ to compare functional visual acuity and eye-related quality of life between Chinese myopic children aged 12-17 years wearing OK contact lenses and SVS and the impact of diferent myopia correction methods on parents and families to serve as a guide for doctors' choices of correction methods.…”