Objective

To measure and compare the vision-related quality of life between Chinese children wearing orthokeratology (ortho-k) lenses and single vision spectacles, to understand acceptance of ortho-k treatment by children in China.

Methods

Subjects of Chinese origin, with myopia of -5.00 to -0.75 D, astigmatism < 1.50 D were recruited. All subjects had been wearing optical correction – ortho-k lenses or single vision spectacles (SVS), for the past 12–18 months and were aged between 8–12 years. The Pediatric Refractive Error Profile (PREP) questionnaire, translated to Chinese, was used to evaluate the perceptions of children wearing spectacles in overall vision, near vision, far vision, symptoms, appearance, satisfaction, activities, academic performance, handling of optical corrections, and peer perceptions. PREP questions, rephrased to address the same issues for ortho-k subjects who did not wear spectacles in the daytime, were used for ortho-k wearers (PREP-OK). The mean score of all items was calculated as the overall score. For ortho-k wearers, four additional questions on experience and frequency of symptoms: experiencing difficulty in falling asleep, ocular discomfort, itchy/burning/dry eyes, and foreign body sensation during ortho-k lens wear at night were asked and reported separately.

Results

Forty subjects (20 ortho-k, 20 SVS) completed the study. Overall vision, far vision, appearance, satisfaction, activities, and peer perception scores in the ortho-k group were significantly better than the SVS group (all P < 0.05). Handling of optical correction score in the ortho-k group was significantly worse than the SVS group (P = 0.04). No significant differences in near vision, symptoms in the daytime and academic performance were found between two groups (P > 0.05). With respect to symptoms during ortho-k lens wear at night, none of the subjects reported difficulty in falling asleep, but 30–40 % of subjects reported occasional ocular discomfort, itchy/burning/dry eyes, and foreign body sensation after lens insertion.

Conclusion

Although ortho-k may induce some ocular discomfort with lens wear during the night, these were infrequent and the benefits from ortho-k can compensate for the discomfort, leading to better vision-related quality of life in Chinese children, compared with those wearing SVS.