Spectacle wear in children reduces parental health-related quality of life

Abstract

Purpose To investigate whether spectacle wear in children affects responses on the Intermittent Exotropia Questionnaire (IXTQ) or the Pediatric Quality of Life Inventory (PedsQL). Methods We recruited 49 children, median age 8 years (range, 5–13), presenting with visual acuity 20/40 or better and an otherwise normal eye examination (no strabismus), who either had no refractive error (n = 29) or had refractive error corrected with spectacles (n = 20). The IXTQ and PedsQL were completed, each comprising a child report (Child IXTQ, Child PedsQL) and a parent proxy report (Proxy IXTQ, Proxy PedsQL). In addition, the IXTQ contains a parent self-report (Parent IXTQ). Each questionnaire is scored from 0 (worst health-related quality of life [HRQOL]) to 100 (best HRQOL). Median scores were compared using Wilcoxon rank-sum tests. Results Child IXTQ and Proxy IXTQ scores were similar between groups; nevertheless, Parent IXTQ scores were lower for spectacle wearers (90.4 vs 97.1, p = 0.01). Parent IXTQ questions that scored lower in the spectacle group were related to parental worry about permanent damage to their child’s eyes, longterm eyesight, surgery, self-consciousness, and teasing. The PedsQL composite scores and all subscale scores were similar between spectacle wearers and nonspectacle wearers, both for Child PedsQL and Proxy PedsQL. Conclusions Parental HRQOL, measured using the Parent IXTQ, was lower for children wearing spectacles than for children who did not wear spectacles. There was no difference between spectacle and no-spectacle groups using either Child IXTQ, Proxy IXTQ, Child PedsQL, or Proxy PedsQL.

Health-related quality of life in parents of children with intermittent exotropia

“…It is also possible that parents of children with even more severe intermittent exotropia might have responded differently, nevertheless our cohort of children with intermittent exotropia included a wide spectrum of severity. Another potential limitation was the difference in proportions of children in each group wearing spectacles, because spectacle wear alone affects parental health-related quality of life, when measured with the Parent IXTQ 12. Nevertheless, the intermittent exotropia cohort in the present study had a lower proportion of spectacle wear than the visually normal cohort, which would potentially bias against finding an effect of intermittent exotropia on Parental HRQOL, but we still found an effect.In addition, our normal threshold may have been slightly depressed by a spectacle effect, resulting in a lower proportion of parents of children with intermittent exotropia reporting subnormal HRQOL.…”

Childhood intermittent exotropia from a different angle: does severity affect quality of life?

“…As spectacle wear may be a potential confounding factor for HRQOL,15 we further adjusted for the effect of spectacle use using partial correlations for all the variables listed in table 1. Of the eight associations found, all remained statistically significant (p<0.05) except for two items, which became borderline significant (p>>0.05):

Poorer proxy mean scores were correlated with poorer home control (r=−0.3188, p=0.0085), and angle of deviation (distance) (r=−0.2970, p=0.0147)

Poorer parent mean scores were correlated with poorer office control (near) (r=−0.2760, p=0.0238)

Poorer parent psychological subscale scores were correlated with poorer office control (near) (r=−0.3415, p=0.0047) and larger angle of deviation (distance) (r=−0.2339, p=0.0567)

Poorer parent surgery subscale scores were correlated with poorer distance control (r=−0.2259, p=0.0660), near control (r=−0.2837, p=0.0200) and office control (near) (r=−0.2906, p=0.0171).

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Specific Health-Related Quality of Life Concerns in Children with Intermittent Exotropia

“…In order to formally measure HRQOL in this population, we previously developed and validated the Intermittent Exotropia Questionnaire (IXTQ), a patient-derived HRQOL instrument for children with intermittent exotropia (XT). (Hatt et al., 2010a, Hatt et al, 2010b, Yamada et al, 2011a, Yamada et al, 2011b) In our previous initial study, Child IXTQ and Proxy IXTQ scores were found to be lower (worse HRQOL) in children with intermittent XT than in normal controls, (Hatt et al, 2010a) nevertheless, responses to individual questionnaire items have not been studied. The purpose of the present study was to assess responses to individual items on Child and Proxy IXTQ on a larger cohort of patients than used in the original validation studies in order to evaluate the impact of specific HRQOL concerns in children with intermittent XT.…”