Impact of Acanthamoeba Keratitis on the Vision-Related Quality of Life of Contact Lens Wearers

Purpose: The aim of this study was to determine the impact of Acanthamoeba keratitis (AK) caused by contact lens (CL) use on vision-related quality of life (VRQOL) and the sociodemographic factors and disease outcome associated with VRQOL. Methods: Sixty-one CL-associated AK cases and 59 asymptomatic CL wearers (mean age +/- SD 39.4 +/- 16.5 vs. 45.5 +/- 15.2 yrs, P = 0.04) were recruited from Moorfields Eye Hospital and Institute for Optometry, London. AK cases were surveyed during active disease and were stratified into poor and good outcomes based on clinical features. VRQOL was measured using Rasch-transformed scores from the Emotional, Mobility, and Reading domains of the 32-item Impact of Visual Impairment questionnaire. AK cases were compared with controls and poor outcomes compared with good with multivariable linear regression. Multivariable linear regression models were also used to identify the sociodemographic factors and disease outcome associated with VRQOL. Results: AK was associated with significant and substantial reductions in all 3 evaluated domains of VRQOL (Reading -59.6%, Mobility -59.8%, and Emotional -66.2%) compared with controls, independent of sociodemographic factors. Patients with AK who experienced poor outcomes, those who were of British White race (compared with all other races) and female, had lower VRQOL scores across all domains. Patients with AK with lower incomes scored worse on Reading and Mobility domains, whereas those with lower education had poorer Emotional scores. Conclusions: AK has a considerable detrimental impact on VRQOL. Clinicians should consider the importance of referring patients with AK for rehabilitative support and counseling as part of active disease management.

Automated summary

This study found that AK has a significant and substantial impact on all three domains of VRQOL, regardless of sociodemographic factors. Patients with AK who experienced poor outcomes, British White race (compared to other races) and female, had lower VRQOL scores across all domains. Lower income patients with AK scored worse on Reading and Mobility domains, while those with lower education had poorer Emotional scores.