BMC Ophthalmology最新文献

{"title":"Baseline ocular biometrics in children with orthokeratology-induced axial length reduction or elongation.","authors":"Xin Ai, Xuehui Zhang, Ruoxin Wang, Yanhong Li","doi":"10.1186/s12886-025-04356-6","DOIUrl":"10.1186/s12886-025-04356-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the baseline ocular biometrics in children with axial length reduction after orthokeratology for better myopia control.</p><p><strong>Methods: </strong>Changes in ocular parameters in 164 subjects who completed one year of Ortho-K treatment were retrospectively reviewed. The subjects were divided into AL reduction (n = 105, ≤ 0 mm/year axial growth) and AL elongation (n = 59, ≥ 0.4 mm/year axial growth) groups based on 1-year axial length changes.</p><p><strong>Results: </strong>Compared with those in the AL elongation group, children in the AL reduction group were older (p < 0.001), had a higher degree of myopia(p < 0.001), larger pupil diameter (p < 0.001), deeper anterior chamber depth (p = 0.007), and lower corneal endothelial density (p < 0.001). In the AL reduction group, the reduction was negatively correlated with WTW and CCT changes (ρ=-0.346, p < 0.001). Endothelial cell loss in the elongation group was 1.95 times greater than that in the reduction group (44.239 ± 79.629 vs.22.646 ± 79.038 cells/mm²).</p><p><strong>Conclusions: </strong>Baseline age, degree of myopia, pupil diameter, and anterior chamber depth were associated with the efficacy of orthokeratology in controlling axial length. The ΔWTW/ΔCCT ratio may be useful for predicting AL reduction. Regular examination of the corneal endothelium in children with rapid axial length elongation is recommended.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"498"},"PeriodicalIF":1.7,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to diabetic retinopathy care and barriers to service utilization in Nepal.","authors":"Raba Thapa, Sanjita Sharma, Sunil Thakali, Manish Poudel, Pratibha Neupane, Pradeep Banjara, Ravi Gautam, Sarity Dodson, Lila Raj Puri, M M Sarwar","doi":"10.1186/s12886-025-04336-w","DOIUrl":"10.1186/s12886-025-04336-w","url":null,"abstract":"<p><strong>Background: </strong>Diabetes is an emerging public health problem in low- and middle-income countries. Diabetic Retinopathy (DR) is one of the leading causes of blindness in Nepal. Blindness due to DR can be avoided with timely treatment and regular follow up. This study aimed to assess adherence to DR care, and barriers for DR care service utilization among the patients with DR.</p><p><strong>Methods: </strong>A mixed method study with a retrospective prospective design was conducted. In quantitative part, patients having DR were recruited retrospectively, follow up assessment done for one year to assess the adherence. In qualitative part, the focus group discussion among the patients with DR presented to the hospital from seven provinces of Nepal and national level Key Informant interview (KII) from eye care services and policy level was enrolled. Information regarding the DR care pathway, barriers, enablers, and possible solution for the DR adherence to care were collected. The details of qualitative part will be dealt separately. Patients with DR presented at primary, secondary and tertiary eye care center were enrolled from July 2020 to June 2021. Estimated sample size was 151 patients with DR. Patients were enrolled retrospectively, their one year follow up was assessed and they were also invited for detailed history and evaluation. Data was entered into Open Data Kit (ODK) software, then transferred to IBM SPSS version 20 for analysis.</p><p><strong>Results: </strong>Total of 140 (92.7%) participants were available for detailed evaluation. Mean age was 59.5 years (SD: 10.0; range: 36 to 82 years). Two thirds (68%) were males. Two thirds (67.1%) were from tertiary eye care center. Mild and moderate non-proliferative DR (NPDR) accounted for 65.7%. Proliferative DR (PDR) (14.3%), and severe NPDR with clinically significant macular edema (CSME) comprised of 12.2%. Overall, 62 patients with DR (44.3%) adhered to DR care. Mild NPDR and PDR without CSME had the highest adherence to DR care each of 60%. DR adherence to care was 42.9% at primary, 40.6% at secondary and 45.7% at tertiary eye care center. Paid employment was statistically significant association with DR adherence (p = 0.011). Major barriers for DR adherence to care were lack of knowledge and awareness (62.8%), lack of accompanying person (28.2%), limited time (21.8%) and financial problem (15.4%).</p><p><strong>Conclusions: </strong>DR adherence to care was found in less than half (44.3%) of the patients with DR. Paid employment was significantly associated with higher DR care adherence. Main barriers for DR adherence were lack of knowledge and awareness on DR, lack of accompanying person, and cost of the treatment. Community awareness campaigns on DR and enhance access to treatment is recommended to reduce blindness from DR.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"494"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute bilateral vision loss secondary to cerebral venous thrombosis-induced intracranial hypertension: a case report.","authors":"Pradeep Kumar Panigrahi, Srikanta Kumar Sahoo, Kathasagaram Aruna Gayathri, Suchismita Mishra","doi":"10.1186/s12886-025-04332-0","DOIUrl":"10.1186/s12886-025-04332-0","url":null,"abstract":"<p><strong>Background: </strong>The present case describes a rare presentation of sudden onset acute bilateral vision loss due to cerebral venous thrombosis secondary to malignant rise in intracranial pressure.</p><p><strong>Case presentation: </strong>A 23-year-old male patient presented with sudden onset bilateral loss of vision of one week duration. Best-corrected visual acuity was 6/18, N12, and perception of light in the right and left eye, respectively. Fundus examination revealed papilledema. Magnetic resonance imaging showed thrombotic occlusion of the superior sagittal, straight, and inferior sagittal sinuses. Cerebrospinal fluid opening pressure was elevated to 40 cm H₂O. Laboratory investigations showed the presence of polycythemia (Hemoglobin- 18.6 g/dl) and elevated serum homocysteine (38.64 µmol/L) levels. Early initiation of appropriate treatment resulted in improvement of vision to 6/9, N8 and 6/6, N6 in the right and left eye, respectively. One month following treatment, there was complete resolution of papilledema and retinal haemorrhages in both eyes.</p><p><strong>Conclusion: </strong>Malignant rise in intracranial pressure can rarely lead to the sudden onset bilateral vision loss. Early diagnosis and prompt treatment can be associated with a good visual prognosis.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"493"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reading ability in children with intermittent exotropia and its association with binocular visual function and visual information processing capability.","authors":"Yan Yang, Jinen Hou, Hailu Huang, Cong Wei, Jingsen Chen, Tong Wu, Junyi Liu, Daming Deng, Shihui Ling, Wenhan Yang, Jianhua Yan, Shuai Chang, Xinping Yu","doi":"10.1186/s12886-025-04326-y","DOIUrl":"10.1186/s12886-025-04326-y","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate children's reading performance with intermittent exotropia (IXT) and investigate possible associations among reading abnormalities, binocular visual function, and visual information processing.</p><p><strong>Methods: </strong>This cross-sectional, case-control study involved 61 children with basic-type IXT and 40 healthy controls aged 7 to 13. Reading performance was assessed objectively using the Development Eye Movement (DEM) test and subjectively with the Dyslexia Checklist for Chinese Children (DCCC). Binocular visual function assessments included fusion, stereopsis, and contrast sensitivity. Visual information processing was evaluated using the Test of Visual Perceptual Skills (TVPS-4) and Beery Visual Motor Integration (VMI-6).</p><p><strong>Results: </strong>Children with IXT exhibited significantly poorer performance on both the horizontal (p = 0.04) and vertical subtests (p = 0.048, p = 0.023, p = 0.037 under different viewing conditions) of the DEM test compared to controls. DCCC questionnaire responses indicated greater difficulties among children with IXT in reading, oral language, written expression, reading habits, attention, and vocabulary comprehension (all p < 0.05). Additionally, children with IXT demonstrated significantly reduced stereopsis, fusion, and contrast sensitivity (all p < 0.05). Scores for visual perception (assessed with TVPS-4) and visual-motor integration (assessed with VMI-6) were also lower in the IXT group (p = 0.003 and p = 0.008, respectively). Stepwise multivariate analysis identified visual-motor integration as an independent predictor of DEM reading performance (p = 0.005), accounting for 11% of the variance in reading ability among children with IXT.</p><p><strong>Conclusion: </strong>Children with intermittent exotropia exhibit reduced reading performance, with visual-motor integration possibly as a key factor. Clinical interventions may benefit from focusing on enhancing visual-motor integration.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"497"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel shape-memory Bi-hook device for nasolacrimal duct stent implantation in canalicular laceration repair.","authors":"Juan Zhang, Houshuo Li, Ranran Chen, Khusbu Keyal, Shen Qu, Yunli Niu, Yanlong Bi","doi":"10.1186/s12886-025-04333-z","DOIUrl":"10.1186/s12886-025-04333-z","url":null,"abstract":"","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"495"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of tear lipid biomarkers in women with dry eye disease and the impact of intense pulsed light therapy: a case-control study.","authors":"Arantxa Acera, Oliver Ibarrondo, Antonio J Mateo-Orobia, Xandra Pereiro, Beatriz Abad-García, Silvia López-Plandolit, Noelia Ruzafa, María Romero, Alejandro Blasco-Martínez, Francisco D Rodríguez, Juan A Duran, Elena Vecino","doi":"10.1186/s12886-025-04315-1","DOIUrl":"10.1186/s12886-025-04315-1","url":null,"abstract":"<p><strong>Background: </strong>The tear-film lipid layer (TFLL) constitutes the outermost barrier of the ocular surface, reducing evaporation and stabilising the tear film. In aqueous-deficient dry eye (ADDE) and Meibomian-gland dysfunction (MGD), compositional changes in the TFLL compromise this protective role. The present study was designed to characterise the tear-lipid fingerprints associated with ADDE and MGD, to compare them with those of healthy subjects, and to assess the impact of intense pulsed-light (IPL) therapy on the tear lipidome in MGD.</p><p><strong>Methods: </strong>In a multicentre, prospective, observational-interventional case-control pilot study, 52 participants were enrolled in two phases: a discovery cohort (9 ADDE, 15 MGD, 13 controls) and an independent validation cohort (15 additional subjects). Tear lipids were profiled by ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS). Unsupervised principal-component analysis (PCA) explored global variance; supervised partial least-squares discriminant analysis (PLS-DA) and orthogonal PLS-DA (OPLS-DA) defined group differences and yielded candidate biomarkers, with model robustness confirmed by permutation testing and CV-ANOVA. MGD participants received IPL at baseline, day 15, and day 45; clinical metrics and tear samples were obtained before and after therapy.</p><p><strong>Results: </strong>A total of 176 lipid species were identified and quantified in positive- and negative-ion modes (ESI + and ESI-). Supervised PLS-DA clearly separated ADDE, MGD and control samples, while OPLS-DA highlighted 48 lipids that differed significantly among groups (p < 0.05). Both dry-eye subtypes were characterised by a pronounced depletion of lysophospholipids (LPE, LPC, LPG, LPI; fold change < 0.5) and an enrichment of (O-acyl)-ω-hydroxy fatty acids (OAHFA; fold change > 2) relative to controls. Cholesteryl esters (ChE) showed a subtype-specific elevation only in the MGD-versus-control comparison (fold change > 2). Permutation testing and CV-ANOVA confirmed the robustness of the ADDE-versus-MGD discrimination model. Although IPL therapy significantly improved clinical metrics such as tear break-up time and lissamine-green staining, the changes observed in the tear lipid profile were not statistically significant.</p><p><strong>Conclusions: </strong>Dry-eye subtypes appear to possess discrete lipidomic signatures; consequently, the lipid panel identified here could serve as a set of potential therapeutic targets. The dissociation between clinical improvement and lipidomic stability after IPL indicates that the therapy may benefit the ocular surface through mechanisms other than large-scale remodelling of the tear-film lipid layer, highlighting the need to explore complementary therapeutic pathways.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"496"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of slanted lateral rectus recession on pediatric patients with convergence insufficiency intermittent exotropia.","authors":"Na Feng, Lijun Zhang, Mengyao Guo, Fang Feng, Liusen Yang, Houbin Huang","doi":"10.1186/s12886-025-04306-2","DOIUrl":"https://doi.org/10.1186/s12886-025-04306-2","url":null,"abstract":"<p><strong>Background: </strong>Convergence insufficiency intermittent exotropia (CIX(T)) is a common type of strabismus in children, characterized by greater ocular deviation at near fixation compared to distance fixation. This study aimed to explore impact of slanted lateral rectus recession (S-LRc) compared to conventional lateral rectus recession (LR) on pediatric patients with CIX(T).</p><p><strong>Methods: </strong>This retrospective study enrolled pediatric patients with CIX(T) at Shanxi Aier Eye Hospital between June 2022 and December 2024. Pediatric patients with CIX(T) were divided into the S-LRc group and the LR group based on the surgical technique. In the S-LRc group, the lower pole of the lateral rectus muscle was recessed more than the upper pole to achieve greater correction at near. The primary outcome was postoperative horizontal eye position (orthotropia, overcorrection, or undercorrection). Secondary outcomes included near-distance deviation difference (NDD) and binocular visual function (simultaneous vision, fusion and static stereopsis) postoperatively.</p><p><strong>Results: </strong>A total of 80 pediatric patients with CIX(T) were included in the study, divided into the LR group (n = 20) and the S-LRc group (n = 60). At six months postoperatively, there was a significant difference in distribution of postoperative horizontal eye position (12/1/7 vs. 55/3/1, P = 0.003) and NDD improvements (10 ± 4.29 vs. 13.37 ± 5.19, P = 0.012) between LR group and S-LRc group. In terms of binocular fusion, there were no significance in simultaneous vision (80.0% vs. 63.8%, P = 0.861), fusion (80.0% vs. 98.0%, P = 0.110) and static stereopsis (45.0% vs. 50.0%, P = 0.698) between LR group and S-LRc group.</p><p><strong>Conclusions: </strong>There were significant difference in horizontal eye position and NDD improvement, but both LR and S-LRc performed comparably in binocular fusion function in pediatric CIX(T) patients. These findings highlight the potential of S-LRc in improving short-term alignment and convergence control in pediatric CIX(T). Longer follow-up studies are needed to assess recurrence and sustained binocular outcomes.</p><p><strong>Clinical trial number: </strong>not applicable.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"491"},"PeriodicalIF":1.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Choroidal hemangioma in Sturge-Weber syndrome elucidated by ultra-widefield swept-source optical coherence tomography angiography.","authors":"Zhiyue Zhang, Ruilin Zhu, Liu Yang","doi":"10.1186/s12886-025-04297-0","DOIUrl":"https://doi.org/10.1186/s12886-025-04297-0","url":null,"abstract":"","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"492"},"PeriodicalIF":1.7,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A nomogram for identifying premyopia and myopia candidates in Chinese children: focusing on those with cycloplegic spherical equivalent refraction ≤ + 0.75D.","authors":"Jing Wu, Cong Zhang, Jingying Wang","doi":"10.1186/s12886-025-04278-3","DOIUrl":"10.1186/s12886-025-04278-3","url":null,"abstract":"<p><strong>Background: </strong>Primary refractive error screening parameters are commonly employed in clinical and community settings before cycloplegic assessment of myopia, however, their utility in identifying premyopia and myopia intervention candidates remains underexplored. This study aimed to develop a nomogram based on these routinely measured parameters to support clinical decision-making for premyopia and myopia prevention.</p><p><strong>Methods: </strong>Pediatric patients (aged 4-17 years) from two medical centers in China were enrolled in this retrospective cohort study. A predictive model for the candidates of premyopia and myopia intervention was developed using logistic regression with multiple imputations. The model included the following primary screening parameters: age, gender, uncorrected visual acuity (UCVA), average corneal curvature (ACC), non-cycloplegic spherical equivalent refraction (NCSER), axial length (AL), and the axial length to average corneal radius of curvature (AL/ACRC) ratio. The efficacy of the model was assessed using the area under the receiver operating characteristic (ROC) curve, calibration curves, and decision curve analysis (DCA). R was employed to conduct all statistical analyses.</p><p><strong>Results: </strong>A total of 1006 participants (507 females, 499 boys) were enrolled, with 87.4% demonstrating cycloplegic spherical equivalent refraction (CSER) ≤ + 0.75D. In multivariate logistic regression, UCVA, NCSER, AL, and AL/ACRC were identified as independent predictors. These predictors were incorporated into a nomogram to predict the candidates for premyopia and myopia intervention. The nomogram exhibited exceptional discrimination in the derivation set (AUC = 0.971, 95% CI: 0.957-0.984), whereas in the external validation set, the AUC was 0.921 (95% CI: 0.866-0.976) when a cutoff of 0.851 in derivation set was employed. Calibration was verified through the calibration curve and Hosmer-Lemeshow tests (P = 0.99 and P = 0.96, respectively), and the decision curve analysis demonstrated robust clinical utility for threshold probabilities of 0.10-1.00 in the derivation set and 0.20-1.00 in the external validation set.</p><p><strong>Conclusion: </strong>The nomogram derived from the parameters of primary refractive error screening has the potential to preliminarily predict premyopia and myopia intervention candidates, thereby facilitating clinical decision-making in the context of premyopia and myopia prevention.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"490"},"PeriodicalIF":1.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Keratoconus and quality of life: an updated comprehensive review.","authors":"Seyed Mohsen Rafizadeh, Ghazal Ghochani, Foroozan Narooie-Noori, Masoud Khorrami-Nejad","doi":"10.1186/s12886-025-04320-4","DOIUrl":"10.1186/s12886-025-04320-4","url":null,"abstract":"<p><p>Keratoconus (KCN), a progressive ectatic corneal disorder, significantly impacts vision-related quality of life (VRQoL) beyond reduced visual acuity. This review aims to comprehensively examine the impact of keratoconus on patients' quality of life (QoL), considering its economic burden and the effectiveness of various treatment modalities in improving QoL outcomes. KCN profoundly impacts VRQoL, exceeding the effects of reduced visual acuity alone. Multiple factors contribute: refractive errors (leading to challenges with spectacle and contact lens correction, impacting comfort and convenience), decreased contrast sensitivity (hindering daily activities like driving and reading), ocular pain and discomfort (often stemming from the disease itself or treatment), and associated comorbidities (such as vernal keratoconjunctivitis, further compromising ocular health). Disease severity significantly influences VRQoL, with more advanced KCN generally linked to lower QoL scores, although this correlation is not consistently observed across studies. Demographic variations also play a role, with differences noted across genders and age groups in various studies. Nonsurgical options include spectacles (effective in early stages only), contact lenses (soft, rigid gas permeable, and scleral lenses offering varying degrees of visual correction and comfort), each impacting QoL differently based on visual improvement, comfort, and cost. Surgical interventions, such as corneal collagen crosslinking, indirectly improve QoL by stabilizing vision; however, they may not fully restore visual acuity and involve a period of postoperative discomfort. Intracorneal ring segments improve corneal shape and refractive errors, enhancing visual acuity and potentially QoL, but long-term effects and suitability depend on disease stability. Corneal transplantation, reserved for advanced cases, significantly improves vision and QoL for many patients, but it is an invasive procedure with potential complications and a recovery period that can impact QoL. Combined treatment approaches may optimize outcomes, but the optimal strategy remains individualized based on disease severity, patient preferences, and resource access. Ultimately, successful KCN management hinges on a balance of objective visual improvements and subjective QoL enhancements.</p>","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":"25 1","pages":"489"},"PeriodicalIF":1.7,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144942379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}