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T. Yamada, S. R. Hatt, D. A. Leske, J. M. Holmes; The Effect of Spectacle Wear on Health Related Quality of Life Measured Using the Intermittent Exotropia Questionnaire. Invest. Ophthalmol. Vis. Sci. 2009;50(13):1986.
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To investigate the effect of spectacles on the health related quality of life (HRQOL) of children and their parents using the new Intermittent Exotropia Questionnaire (IXTQ) and the PedsQL questionnaire. We were specifically interested in whether spectacle wear affected IXTQ scores.
We recruited 41 children, median age 8 years (range 5 to 13), presenting with normal visual acuity (20/40 or better) and an otherwise normal eye examination (specifically no strabismus), who either had no refractive error (n=28) or had refractive error corrected with spectacles (n=13). One parent was recruited with each child. The IXTQ and PedsQL were completed, each comprised of a Child survey (self-report by child) and a Proxy survey (Child’s HRQOL from parent perspective). In addition, the IXTQ contains a Parent survey (self-report of the parent’s own HRQOL). Each questionnaire was scored from 0 (worst HRQOL) to 100 (best HRQOL). Median scores were calculated for each group (spectacles vs. no spectacles) and compared using Wilcoxon rank sum tests.
Child IXTQ scores were similar between both groups (92 with spectacles vs 90 without, P= 0.7) but Proxy IXTQ scores were lower for spectacle wearers (94 vs 100, P = 0.04). Proxy questions that scored lower in the spectacle group were related to teasing and feeling different. Parent IXTQ scores were lower for spectacle wearers (90 vs 97, P=0.002). Parent questions that scored lower in the spectacle group were related to parental worry about vision, surgery, self consciousness, and teasing. In contrast, for the PedsQL, composite scores and all subscale scores were similar between spectacle wearers and non-spectacle wearers, both for Child surveys (composite 82 vs 84, P>0.7 for all comparisons) and Proxy surveys (composite 96 vs 94, P>0.2 for all comparisons).
HRQOL, as perceived by the parent, was lower for children wearing spectacles than that of children who did not wear spectacles using the Proxy IXTQ. Parental worry about their children wearing spectacles was also apparent using the Parent IXTQ questionnaire. Future uses of the IXTQ for intermittent exotropia need to account for spectacle wear.
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