Impact of Ocular Conditions and Improvements After Refractive Surgery in Quality of Life for Children With Neurodevelopmental Disorders

Alexandra Zdonczyk, Lawrence Tychsen, John N. Constantino, Susan M. Culican, Amer Al Badawi, Margaret Reynolds

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


PURPOSE: This study aims to characterize the eye-related quality of life of children with neurodevelopmental and ocular disorders at baseline and after refractive surgery. DESIGN: Prospective interventional case series. METHODS: We enrolled children and adolescents 5 to 18 of age with neurodevelopmental disorders undergoing refractive surgery (6 for pre-/postsurgical assessment and 14 for baseline analysis). Eye-related quality of life was measured using the Pediatric Eye Questionnaire (PedEyeQ). Baseline levels of adaptive functioning and social behaviors were measured using the Adaptive Behavioral Assessment System (ABAS-3) and Social Responsiveness Scale (SRS-2). We assessed the correlation between baseline PedEyeQ scores, number of ocular comorbidities, magnitude of refractive error, and ABAS-3 and SRS-2 scores. RESULTS: At baseline, 14 patients demonstrated decreased median eye-related quality of life (<60/100) in 5 of 9 PedEyeQ domains, moderate deficiencies in social behaviors (SRS-2 median 71, range 49-90), and low adaptive functioning (ABAS-3 median percentile for age of 0.100). Baseline PedEyeQ scores did not correlate with magnitude of refractive error or adaptive functioning scores but did correlate with number of ocular comorbidities and social behavior scores. Six patients have undergone refractive surgery without complication. Postoperatively, 11 of 11 eyes were within ±1.5 diopters spherical equivalent. Four of 6 patients exhibited clinically significant improvements in PedEyeQ scores after surgery. CONCLUSIONS: Even in the presence of significant social and adaptive impairments, quality of life in children with neurodevelopmental disorders is decreased by ocular disorders. Refractive surgery is associated with clinically significant improvements in eye-related quality of life.

Original languageEnglish (US)
Pages (from-to)9-17
Number of pages9
JournalAmerican journal of ophthalmology
StatePublished - Mar 2023

Bibliographical note

Funding Information:
Funding/Support: This publication was supported by the Knights Templar Foundation, Foundation Fighting Blindness, the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number TL1TR002344, and the Washington University Dean's Medical Student Research Fellowship for the Yearlong Research Program. This work was also supported by an unrestricted grant to the Department of Ophthalmology and Visual Sciences from Research to Prevent Blindness. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2022 Elsevier Inc.

PubMed: MeSH publication types

  • Journal Article
  • Research Support, N.I.H., Extramural


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