December 1, 2021
By Dwight Akerman, OD, MBA, FAAO, FBCLA
This review aims to address how various myopia management treatments affect the patient’s quality of life. Success in the treatment of eye disease is often measured by vision improvement, resolution of visible pathology, and change in objective testing measures. Contemporary trends in medical care have shifted focus from these objective measures of success to the patient’s assessment of success based on scoring results from validated questionnaires.
Lipson et al. discuss vision-related quality of life (VR-QoL) assessment on the most effective and most commonly prescribed interventions to slow axial elongation and myopia progression. These interventions include orthokeratology, multifocal soft contact lenses, atropine eye drops, and myopia controlling spectacles. Because myopia management (MM) is prescribed almost exclusively for children, this review focuses on how these interventions impact children’s VR-QoL.
In the near term, studies described in this review show VR-QoL is higher with children using orthokeratology versus those wearing single vision spectacles or single vision soft contact lenses. Also, VR-QoL is higher in children wearing single vision soft contact lenses versus those wearing single vision spectacles. Studies on the effect of using low-dose atropine on VR-QoL are limited. Myopia controlling spectacles (MCS) are new and have not been studied for their impact on VR-QoL. Future study to evaluate their impact on VR-QoL and how MCS compares to other MM modalities is warranted.
This review demonstrates that there are numerous factors that may impact VR-QoL to evaluate in the decision-making process when eye care providers consider when, how, and if to prescribe myopia management for children with myopia.
Vision-Related Quality of Life with Myopia Management: A Review
Michael J. Lipson, Brittany Boland, Colm McAlinden
The disease of myopia has come into focus as a worldwide public health concern. Myopia has shown increasing prevalence, incidence at an earlier age, and progression to a higher degree. Progressive increase in the degree of myopia is strongly associated with an increase in axial length of the eye. Various interventions have been shown to slow axial elongation in children. These interventions have been studied to assess efficacy in slowing axial elongation and correction of vision. In addition, research into quality of vision, risk of adverse events, overall safety, and impact on vision-related quality (VR-QoL) of life has been pursued. In contrast, studies have been published to demonstrate the risks of myopia, high myopia, and increased axial length. This review will discuss VR-QoL assessment on the most effective and most commonly prescribed interventions to slow axial elongation and myopia progression. The patient attributes considered are VR-QoL scores from validated instruments. The development and use of validated survey instruments to assess the patient-reported outcomes is discussed. The review demonstrates that there are numerous factors that may impact VR-QoL to evaluate in the decision-making process when eye care providers consider when, how, and if to prescribe myopia management (MM) for children with myopia.
Michael J. Lipson, Brittany Boland, Colm McAlinden. Vision-related quality of life with myopia management: A review, Contact Lens and Anterior Eye. 2021 Nov 18;101536. [Online ahead of print]