Vision Specific Quality of Life of Pediatric Contact Lens Wearers
Several studies have shown that children are capable of wearing and caring for contact lenses, but it is not known whether the benefits outweigh the risks associated with contact lens wear. The purpose of this article is to compare the vision-related quality of life benefits of children randomized to wear spectacles or contact lenses for 3 years using the Pediatric Refractive Error Profile.
The Pediatric Refractive Error Profile was administered to 484 children who wore glasses at baseline. The children were then randomly assigned to wear contact lenses (n = 247) or spectacles (n = 237) for 3 years. The survey was administered at the baseline examination, at 1 month, and every 6 months for 3 years.
During 3 years, the overall quality of life improved 14.2 +/- 18.1 units for contact lens wearers and 2.1 +/- 14.6 units for spectacle wearers (p < 0.001). In all scales except the visual performance scales (Distance Vision, Near Vision, and Overall Vision), the quality of life improved more for older subjects than younger subjects. The three scales with the largest improvement in quality of life for contact lens wearers were Activities, Appearance, and Satisfaction with Correction.
Myopic children younger than 12 years of age report better vision-related quality of life when they are fit with contact lenses than when they wear glasses. Older children, children who participate in recreational activities, children who are motivated to wear contact lenses, and children who do not like their appearance in glasses will benefit most.
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Available from: J. Daniel Twelker
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ABSTRACT: Nearsightedness (myopia) causes blurry vision when looking at distant objects. Approximately 33% of the population in the United States is nearsighted, and some Asian countries report that up to 80% of children are nearsighted. Several studies have examined a variety of methods (including eye drops, incomplete correction (known as 'undercorrection') of nearsightedness, multifocal lenses and contact lenses) to slow the worsening of nearsightedness. In this review we included 23 clinical investigations of myopia treatments in children. Two studies investigated undercorrection of myopia; twelve studies investigated multifocal spectacles (progressive addition lenses (PALs) or bifocal spectacles); one study investigated bifocal soft contact lenses (BSCLs); one study investigated novel lenses designed to reduce peripheral hyperopic defocus (peripheral vision farsightedness) (i.e. lenses that help to focus peripheral vision as well as central vision); two studies investigated rigid gas permeable contact lenses (RGPCLs); and six studies investigated pharmaceutical eye drops (five of these studies were of anti-muscarinic medications). There was one study that evaluated both multifocal lenses and pharmaceutical eye drops. In all studies the interventions of interest were compared with each other, single vision lenses (SVLs) (spectacles), single vision soft contact lenses (SVSCLs) or placebo. The follow-up period was at least one year for all studies. The largest positive effects for slowing myopia progression were exhibited by anti-muscarinic medications (eye drops), but they either cause light sensitivity or blurred near vision, and are not yet available for use. Multifocal spectacles including PALs and bifocal spectacles were found to yield a small slowing of myopia progression. Undercorrection of myopia was found to increase myopia progression slightly, while RGPCLs were found to have no evidence of effect on myopic eye growth.
Available from: Rafael José Pérez Cambrodí
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ABSTRACT: Introducción Las lentes de contacto mejoran significativa-mente la calidad de vida de niños y adolescentes en la medida en que permiten una mejor estética y por lo tanto un menor rechazo a la corrección refractiva (1,2). Sin embargo, no sólo la estética sino también determinados factores funcionales obligan a considerar esta opción terapéutica. De esta manera condiciones como la afaquia o la ambliopía, altos defectos refractivos además de anormalidades estructurales congénitas y el trau-ma corneal pueden beneficiarse de su uso. Indicaciones Miopía Las lentes de contacto son útiles para la corrección de altos defectos miópicos debido a que permiten conservar el campo visual perifé-rico y reducen en menor medida el tamaño de la imagen que las gafas convencionales. Estas ventajas repercuten en una mejora de las capa-cidades motoras y perceptuales del niño. Hipermetropía Su presencia requiere corrección refractiva con el objeto de evitar la ambliopía o el estra-bismo acomodativo. Las lentes de contacto pro-porcionan en estos casos una mayor efectividad que las gafas porque reducen la demanda aco-modativa y la demanda de la convergencia, eli-minando el efecto prismático base externa inducido por las lentes oftálmicas. De esta manera se produce una disminución aparente del coeficiente AC/A con la consiguiente reducción del ángulo de endotropia o endoforia (3).
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