title: Visual impairment and its impact on health-related quality of life in adolescents.
abstract: OBJECTIVE
  To determine the impact of visual impairment on health-related quality of life (QoL) measures in adolescents.
  
  
  METHODS
  School-based, cross-sectional study.
  
  
  METHODS
  Adolescents aged 11 to 18 years from the Singapore Cohort Study of the Risk Factors for Myopia were analyzed. QoL scores were determined using parallel child-self and parent proxy-report of PedsQL 4.0 Generic Core Scales. Refractive error was measured using the table-mounted autorefractor (model RK5 Canon Inc, Ltd, Tochigiken, Japan) and habitual distance logarithm of the minimal angle of resolution (logMAR) visual acuity charts were used.
  
  
  RESULTS
  Data on 1,249 adolescents and 948 parents were analyzed. The prevalence of better eye presenting visual impairment > 0.3 logMAR was 5.7%. The mean (standard deviation) total, physical, and psychosocial health scores of all adolescents were 83.6 (11.8), 89.9 (11.8), and 80.3 (13.7). Healthy adolescents with visual impairment reported statistically but not clinically lower total (-3.8; 95% confidence interval [CI], -7.1 to -0.5; P = .03), psychosocial (-4.2; 95% CI, -8.1 to -0.3; P = .03), and school functioning scores (-5.5, 95% CI, -10.2 to -0.9; P = .02) than those with normal vision. However, no significant difference was observed in the parent proxy-reported scores between the two groups. Differences in total scores between high (1.9; 95% CI, -0.6 to 4.4) and low-myopes (0.2; 95% CI, -1.3 to 1.6) compared with nonmyopes were not significant. Comparable scores were also reported by hyperopes, astigmatism, and their counterparts, as well as their parents. Concordance between child and parent proxy-report was < 0.07.
  
  
  CONCLUSIONS
  Healthy adolescents with visual impairment experienced statistically though not clinically impaired health related QoL, but refractive errors did not appear to have an impact on QoL.
authors.affiliation: Health Services Research and Evaluation Division, Ministry of Health, Singapore, Republic of Singapore. wong_hwee_bee@moh.gov.sg
authors.forename: Hwee-Bee
authors.initials: HB
authors.lastname: Wong
authors.forename: David
authors.initials: D
authors.lastname: Machin
authors.forename: Say-Beng
authors.initials: SB
authors.lastname: Tan
authors.forename: Tien-Yin
authors.initials: TY
authors.lastname: Wong
authors.forename: Seang-Mei
authors.initials: SM
authors.lastname: Saw
mesh_terms: D000293:Adolescent; D002648:Child; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D011788:Quality of Life / Q000523:psychology*; D012030:Refractive Errors / Q000150:complications / Q000175:diagnosis; D012650:Self Disclosure; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000523:psychology*; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000523:psychology*