The influence of the refractive correction on the vision-related quality of life in keratoconus patients

The aim of this study was to assess the impact of refractive correction [spectacles vs rigid gas-permeable contact lenses (RGP CLs)] on the vision-related quality of life (VR-QoL) obtained with the standardized questionnaire, NEI-VFQ-25, in keratoconus patients compared with healthy myopic subjects. The Spanish version of NEI-VFQ-25 was administered two consecutive times to 25 keratoconus patients (RGP CL wearers) and 25 healthy myopic subjects (RGP and soft CL wearers). The first time was to assess the VR-QoL for spectacle wearing, such as those for refractive correction, and the second time was for CL wearing. Keratoconus patients showed a lower VR-QoL impairment (P < 0.01) than healthy subjects in the total and all subscale score of NEI-VFQ-25 related to wearing spectacles. With CL correction, keratoconus patients showed a VR-QoL improvement with statistically significant differences (P < 0.04) in only four subscales, including distance activities, mental health, color vision and peripheral vision, compared with healthy subjects. In the keratoconus group, compared to spectacle use, CL wear improved the VR-QoL score (P = 0.01) and all subscales except for ocular pain (P < 0.01) and mental health (P = 0.25). The use of the NEI-VFQ-25 to explore the difference in the VR-QoL between healthy subjects and patients with keratoconus provides further evidence of improved VR-QoL with RGP CL wear compared with spectacles in keratoconus patients. RGP CL management in keratoconus patients could minimize the impact of the disease on the patient's well-being.