Analysis of parental decisions to use orthokeratology for myopia control in successful wearers

Abstract

Purpose To investigate factors that influence parental decisions to use orthokeratology (ortho‐k) as a myopia control method for their children, and parents’ perspectives during children’s ortho‐k treatment in a hospital setting. Methods Parents/guardians of children wearing ortho‐k lenses for at least six months were required to complete a face‐to‐face survey to investigate the reasons for choosing ortho‐k and their experience of the treatment. Results Parents/guardians of 128 ortho‐k wearers were recruited from the West China Hospital, Sichuan, China. The majority of the participants (74%) were mothers. Wearers' mean age at the time of the survey was 12.0 ± 2.0 years, with a mean history of ortho‐k lens wear of 20.3 ± 8.0 months. Most participants had learned about ortho‐k through word of mouth (56%) or from ophthalmologists (40%); in China, only ophthalmologists may prescribe ortho‐k. The highest ranked motivation was the rapid progression of their children’s myopia (54%), followed by ophthalmologists’ advice (17%) or participants’ who felt they had obtained enough knowledge (17%) of ortho‐k (Kruskal‐Wallis test, p = 0.002). ‘Effectiveness' was the most common reason that participants decided to use ortho‐k (81%), and potential injury was their major concern (75%). Itchy/sore eye was the most common initial adverse effect experienced with lens wear (22%), while a lost or broken ortho‐k lens was the most frequently reported problem (34%). Parents of older lens wearers were significantly less involved in all procedures (Spearman rank correlation test, all p < 0.001). Most wearers, according to either the participants or the wearers themselves, were willing to wear ortho‐k lenses at treatment commencement (80%), and the most common reason was ‘to avoid having to wear spectacles in the daytime’. Conclusions The most powerful motivation for parents to enrol their children in ortho‐k treatment was the rapid progression of myopia. The main reason why participants chose ortho‐k, which most participants learned of by word of mouth, was the effectiveness of the treatment. During use, the most common symptom reported was itchy or sore eyes, but only initially. Children’s willingness to participate is very important for successful ortho‐k treatment; however, their motivation can be quite different from that of their parents. Ortho‐k is a well‐accepted option for myopia control in children.

Assessment of Satisfaction, Compliance and Side Effects among Long-Term Orthokeratology Wearers

“…Moreover, lens decentration (15.4%) and punctate keratitis (7.9%) were also common problems. These findings corroborate previous studies [ 10 , 11 , 17 ]. Previously, several factors have been proposed to promote lens binding in Ortho-K, such as coated lens, increased viscosity of the tear film, eyelid pressure on the lens, negative hydraulic pressure in the tear film, and reverse-geometry lens designs [ 28 ].…”

“…They learned about Ortho-K through word-of-mouth or from ophthalmologists. A previous study indicated that the acceptance rate for Ortho-K commencement was significantly correlated with high myopia in one of the parents, high education level, and knowledge of Ortho-K for myopia control [ 17 ]. In Taiwan, Ortho-K is a selective treatment for myopia that is not covered by insurance.…”

“…We designed a multiple-index questionnaire after adopting the questionnaires from previous studies [ 4 , 10 , 17 , 18 ] and the Quality-of-Life Impact of Refractive Correction (QIRC) [ 19 ]. The structured questionnaire comprised the following six domains: (i) demographic and background information; (ii) time for near-work and outdoor activities during weekdays and weekends; (iii) wearing behavior and follow-up visit; (iv) satisfaction with Ortho-K and willingness to continue wearing; (v) major discomfort symptoms and grades of severity; and (vi) reasons and major concerns for using Ortho-K.…”

BCLA CLEAR - Orthokeratology

“…A survey conducted in China [222] also revealed that adult caregivers (n = 128) of children (aged eight to 18 years), who had worn ortho-k lenses for at least six months, most often learnt about the treatment through word of mouth (56%) or an ophthalmologist (41%) (the only ortho-k prescribers in China). The greatest motivation for adult caregivers selecting ortho-k was their perceived rapid progression of their child's myopia (57%), in contrast to children who reported freedom from spectacles (61%) as their primary motivator.…”

A Cooperative Management App for Parents with Myopic Children Wearing Orthokeratology Lenses: Mixed Methods Pilot Study

“…Studies have revealed that not only are OK lenses 40–60% more effective than other optical correction methods in reducing axial length growth [ 8 ] but they are also being increasingly accepted by these children and their parents, especially in East Asian countries [ 9 ]. Therefore, the popularity of OK lenses with ophthalmologists, patients, and parents has been steadily increasing [ 10 ].…”