Comparison of Contact Lens Corrected Quality of Vision and Life of Keratoconus and Myopic Patients

PURPOSE To compare and analyze changes in vision quality, subjective symptoms, and psycho-social satisfaction in keratoconus and myopic patients following the wearing of contact lenses. METHODS This study enrolled 25 keratoconus and 25 myopic patients with corrected vision over 0.8 according to the Snellen chart due to treatment with contact lenses. Patients were surveyed prior to the wearing of contact lenses, and again after three months of contact lens usage with a questionnaire about quality of vision and life. The changes in visual function, visual symptoms, and psycho-social well-being before and after contact lens usage were analyzed. RESULTS The keratoconus patients' overall degree of satisfaction was higher than the overall degree of satisfaction of myopic patients, and the motivation for contact lens usage and purpose of contact lens treatment were different in the two groups. Keratoconus patients experienced greater changes in satisfaction, particularly in satisfaction during night activities, short-distance work, and the reading of fine print. Furthermore, they experienced fewer dry eye symptoms but greater foreign body sensations than patients with myopia following treatment with contact lenses. No statistically significant differences in social role functions existed between the two groups. Keratoconus patients had a lower expectation of visual acuity recovery before treatment with contact lenses (Mann-Whitney U-test, p = 0.049) compared to myopic patients, and more anxiety about vision loss following treatment (Wilcoxon signed-rank test, p = 0.018) compared to their level of anxiety about vision loss before treatment with contact lenses. CONCLUSIONS Although the same treatment was applied, keratoconus and myopic patients experienced different types of discomfort and areas of improvement in contact lens corrected vision. Therefore, not only corrected vision, but also subsequent improvement and discomfort outcomes should be considered by patients when choosing contact lens treatment. For patients with mild keratoconus, contact lens treatment may be an efficacious first treatment modality.