Effects of Visual Impairment on the Quality of Life of Children Aged 8 to 18 Years in a Tertiary Referral Center

  • Catherine Joanne B. Valconcha University of the Philippines Sentro Oftalmologico Jose Rizal Department of Visual Sciences
  • Marissa N. Valbuena
  • James Abraham B. Lee
Keywords: Pediatric ophthalmology, visual impairment, quality of life, children, quality of life questionnaire


Background. Vision impairment impacts children’s physical well-being, psychological state, and productivity. The Impact of Vision Impairment for Children (IVI_C) is a vision-specific pediatric instrument designed to assess the effects of visual impairment on the quality of life (QoL) in children aged 8 to 18 years who have no additional disabilities. It measures quality of life to assess the needs of children with low vision and outcomes of interventions by deriving answers from both children and their caregivers.

Objectives. The primary objective of the study was to determine the effect of visual impairment on the quality of life of children aged 8 to 18 years.

Methods. This was an observational, analytical, cross-sectional study conducted at the Outpatient Department of the University of the Philippines-Philippine General Hospital, Sentro Oftalmologico Jose Rizal (SOJR), General and Pediatric Ophthalmology Clinics. We included children 8 to 18 years of age with best corrected visual acuity of less than or equal to 20/40 in the better-seeing eye for the visually impaired (VI) group. The control group included children aged 8 to 18 years with best corrected visual acuity of 20/20 to 20/30 in both eyes. Participants underwent a complete ophthalmologic examination, including the determination of visual acuity using the Early Treatment Diabetic Retinopathy Study( ETDRS ) chart prior to administration of the Filipino version of IVI_C questionnaire. After the ophthalmologic examination and prior to end of the medical consultation, the investigator administered the questionnaire to the children and their parents.

Results. A total of 133 participants were included in the study, 67 in the visually impaired group and 66 in the control group. Participants had a median age of 10 years (range, 8 to 18), and 54% were female. Overall QoL scores and sub-scores across domains were significantly lower in the visually impaired group compared to the control group. The mean total and domain IVI_C scores progressively declined with increasing severity of visual impairment. The mean (±SD) total score ranged from 56 ± 6 in the mildly impaired to 42 ± 8 in the severe bilateral impairment group. On multivariate analysis, the significant predictors of quality of life were visual impairment and age. Quality of life of children with visual impairment is lower by 33.59 points (95% CI -35.82 to -31.36) than those in the control group. The QoL score increased by 0.579 per one unit increase in age. This model explained 87.05% of the variance in the IVI_C scores (p < 0.01).

Conclusion. Children with visual impairment have significantly decreased IVI_C and quality of life scores, overall and across domains. Lower scores are associated with increased severity of visual impairment.


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