Evaluation of keratoconus and its impact on vision-related quality of life

This study adds to the understanding of how different factors affect quality of life in people with keratoconus. To evaluate how various demographic factors, clinical characteristics, and treatment modalities influence quality of life in people with keratoconus. This prospective survey study recruited adult participants (18 years and older) with a history of keratoconus. Demographic information, clinical characteristics, visual and surgical treatment history, and responses to the National Eye Institute 25-Item Visual Functioning Questionnaire (NEI-VFQ-25) were collected. Between June 2022 and June 2023, 40 participants completed the study. The mean age was 40.9 ± 15.1 years, and 70.0% were male. All participants wore contact lenses (52.5% scleral lenses, 45.0% corneal lenses, and 2.5% soft lenses), and 17.5% had a history of corneal crosslinking. Compared to scleral lens wear, corneal lens wear was associated with worse quality of life on the NEI-VFQ-25 overall composite ( p =0.015), general vision ( p =0.02), and mental health ( p =0.052) domains. History of corneal crosslinking was associated with worse quality of life in the NEI-VFQ-25 overall composite ( p =0.002), mental health ( p =0.010), role difficulty ( p =0.045), and dependency ( p =0.021) domains. The five lowest-scoring NEI-VFQ-25 domains in this sample were general health, general vision, ocular pain, mental health, and role difficulties. Factors such as the type of contact lens wear may influence an individual's quality of life. In categories like mental health, general vision, and the overall composite score, scleral lens wearers reported better quality of life. Similarly, surgical treatment history may influence quality of life. Specifically, those with a history of corneal crosslinking reported worse quality of life scores in the categories of mental health, role difficulty, dependency, and the overall composite score. Although these factors were found to be statistically significant, not all reached clinical significance. To determine whether the relationships found in this study are repeatable across different populations, additional studies must be performed. Additionally, eye care providers must consider how different treatment options impact not only a patient's vision and ocular health but also their quality of life.