Research Review

Patient and Parent Perceptions of Myopia Modalities

April 1, 2024

By Nicole Liu, MOptm, PhD Candidate, Brien Holden Vision Institute

parent perception

Photo Credit: EmirMemedovski, Getty Images

A variety of non-surgical options are available for individuals with myopia to improve their distance vision, including spectacles, soft contact lenses (SCL), and orthokeratology lenses. While better vision-related Quality of Life (QoL) with OrthoK lenses compared to spectacles were reported in many studies for both children and adults,1-4 parents’ perspectives (or parental proxy response) are less researched.5 However, parents’ perceptions of their children’s QoL frequently play a significant role in driving healthcare utilization decisions for their children.6,7

One recent study by Lattery et al.8 compared the QoL of myopic adults and children who wore spectacles, SCL, or OrthoK lenses using the Pediatric Refractive Error Profile 2 (PREP2). All participants had worn their correction for at least three years. Results showed that adult OrthoK wearers reported higher satisfaction with vision, activities, and overall QoL compared to spectacle wearers. Children wearing OrthoK also reported higher scores for activities compared to SCL and spectacle wearers. More importantly, the authors compared responses to the same survey (PREP2) between parents and their child, with parents providing answers based on their perception of their child’s responses.

Interestingly, parents of contact lens wearers perceived higher QoL in various aspects compared to parents of child spectacle wearers. Despite children expressing overall satisfaction with any form of correction, parents perceived contact lenses as easier for their children to handle than spectacles, possibly due to less risk of damage or loss. They also believed contact lenses were better for their child’s social interactions and appearance.

In conclusion, the authors recommend that practitioners consider parents’ higher preference for contact lenses, especially OrthoK, and how these preferences influence decision-making, compliance, and overall eye health outcomes.



Patient and Parent Perceptions of Myopia Modalities

Lauren J. Lattery, Cecilia Chao, Jeffrey J. Walline, Mark A. Bullimore, Eric R. Ritchey, Kelsea Skidmore, Kathryn Richdale

Purpose: This study compared quality of life (QoL) of myopic adults and children who were established spectacle, soft contact lens (SCL), or orthokeratology (OK) wearers as well as parent/child responses using Pediatric Refractive Error Profile 2 (PREP2).

Methods: Forty-eight adults (aged 18–26 years), 49 children (aged 9–17 years), and the children’s parent completed PREP2, with 7 subscales (symptoms, vision, activities, appearance, peer perception, handling, and overall). Adults and children must have worn their correction for at least three years. Parents were asked to answer how they thought their child would answer. Scores were compared between age groups, among correction groups, and between children and their parents using non-parametric ANOVA, Mann-Whitney U, and Wilcoxon Signed-Rank tests, as appropriate. Post-hoc pairwise comparisons among correction groups were conducted with Bonferroni adjustment.

Results: Average age of adults was 22 ± 2 and for children was 14 ± 2 years, and the duration of correction use was 8 ± 3 for adults and 5 ± 2 years for children (both p < 0.01). Adult OK wearers were more satisfied with vision (p = 0.04), activities (p < 0.001), and overall (p = 0.03) compared to spectacle wearers. Children OK wearers reported higher scores for activities than SCL (p = 0.048) and spectacle wearers (p < 0.001). Parents of contact lens wearers reported higher perceived QoL for activities (OK p < 0.001; SCL p = 0.02), handling (OK p = 0.02; SCL p < 0.001), appearance (SCL p = 0.001), and overall (OK p = 0.001; SCL p < 0.001) subscales than parents of child spectacle wearers.

Conclusion: Activity-driven children and adults perceive significant benefits from OK over spectacles. Parents’ perceptions did not align with their children’s perceptions of their correction.

Lattery, L. J., Chao, C., Walline, J. J., Bullimore, M. A., Ritchey, E. R., Skidmore, K., & Richdale, K. (2023). Patient and parent perceptions of myopia modalities. Contact Lens and Anterior Eye46(2), 101772.



Nicole Liu is a current PhD candidate at UNSW School of Optometry and Vision Science and Brien Holden Vision Institute, under the supervision of Professor Padmaja Sankaridurg and Associate Professor Thomas John Naduvilath. Dr. Liu received her Bachelor of Clinical Medicine (Optometry and Ophthalmology) from Tianjin Medical University in China before obtaining her Master of Optometry degree in 2012 at UNSW. After working as a clinical research optometrist for a few years, she decided to pursue a PhD degree in optometry. She has been awarded the inaugural Dr. David Wilson Memorial Scholarship for her PhD. She was also awarded the ARVO Travel Grant and the ISCLR Student Abstract Grant in 2022 for her research on myopia and circadian rhythm.



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  2. Mohd-Ali B, Low YC, Mohamad Shahimin M, et al. Comparison of vision-related quality of life between wearing Orthokeratology lenses and spectacles in myopic children living in Kuala Lumpur. Cont Lens Anterior Eye. Feb 2023;46(1):101774. doi:10.1016/j.clae.2022.101774
  3. Yang B, Ma X, Liu L, Cho P. Vision-related quality of life of Chinese children undergoing orthokeratology treatment compared to single vision spectacles. Cont Lens Anterior Eye. Aug 2021;44(4):101350. doi:10.1016/j.clae.2020.07.001
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