The effects on visual functions and vision-related quality-of-life after fitting of scleral lenses in keratoconus

Svein Magne Roten; Eilin Lundanes; Vibeke Sundling

doi:10.15626/hn1x1e84

Authors

Svein Magne Roten University of South-Eastern Norway/Specsavers Strømmen https://orcid.org/0009-0004-7172-8653
Eilin Lundanes University of South-Eastern Norway https://orcid.org/0009-0000-3872-5531
Vibeke Sundling University of South-Eastern Norway https://orcid.org/0000-0002-9567-239X

DOI:

https://doi.org/10.15626/hn1x1e84

Keywords:

Scleral lenses, keratoconus, visual acuity, contrast sensitivity, vision-related quality-of-life

Abstract

The purpose of this study was to explore the effects of fitting scleral lenses on visual acuity (VA), contrast sensitivity (CS) and vision-related quality-of-life (VR-QoL) in persons with keratoconus.

An intervention study was undertaken, with a clinical experimental, uncontrolled, single-arm intervention design. The intervention was fitting of scleral lenses to optically correct keratoconus. The outcome measures were monocular and binocular VA at distance and near, CS, and patient-reported VR-QoL using the novel Keratoconus Outcomes Research Questionnaire (KORQ) and National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25).

Twenty-nine participants (54 eyes) were fitted with scleral lenses. Statistically significant improvements were evident between habitual correction and scleral lens correction for all measures including monocular and binocular VA at distance and near (p < 0.001), CS (p < 0.001), KORQ activity limitations subscale (p < 0.001), KORQ symptoms subscale (p < 0.001) and NEI VFQ-25 composite score (p < 0.001). Additionally, asymmetry in VA between eyes improved significantly with scleral lenses (p < 0.001). Spearman correlations showed moderate correlations between improvements in KORQ activity limitations score, VA and CS, improvements in KORQ symptoms score and distance VA, and improvements in the NEI-VFQ-25 near subscale score and near VA.

Fitting scleral lenses significantly improved VR-QoL and visual function in individuals with keratoconus. Although the correlation between improvements in VR-QoL and VA and CS was modest, the findings suggest that individuals with keratoconus should be offered the opportunity to explore scleral lenses as a treatment option to optimise both visual function and VR-QoL. However, as the study used an uncontrolled single-arm intervention design, the results should be interpreted with caution. Future studies including a comparison group are needed to confirm these findings.

Keywords: scleral lenses, keratoconus, visual acuity, contrast sensitivity, vision-related quality-of-life

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