Allergic conjunctivitis (AC) is a common allergic condition that occurs frequently in pediatric patients. In a publication in JAMA Ophthalmology, researchers attempted to explore the impact of AC symptoms on overall patient/caregiver quality of life.

Zhang et al conducted a prospective case-control trial from November 16, 2019, through January 20, 2020. The study participants consisted of 92 children with AC aged 5 to 18 years and their parents and 96 healthy, age-matched pediatric control patients and their parents. The 92 pediatric patients in the AC group were subdivided into cohorts with vernal keratoconjunctivitis (VKC) (23 [25.0%]) or atopic keratoconjunctivitis (AKC) (7 [7.6%]) and seasonal allergic conjunctivitis (SAC) (26 [28.3%]) or perennial allergic conjunctivitis (PAC) (36 [39.1%]).

The objective of the study was to assess the correlation between AC and health-related quality of life (QOL) in pediatric patients and their parents. The primary outcomes and measures were the Pediatric Quality of Life Inventory, version 4.0 (PedsQL), scores for children and their parents. PedsQL scores range from 0 to 100, with higher scores indicating better health-related QOL and fewer negative aspects. The results revealed that in the AC group, 77 of 92 (83.7%) participants were boys and 67 (72.8%) of the parents were women. In the control group, 55 of 96 (57.3%) children were girls and 76 (79.2%) of the parents were women.

The average total PedsQL scores were reduced in both pediatric patients with AC (69.6 [interquartile range [IQR], 66.3-72.8 vs. 96.7; IQR, 92.7-98.9; P < .001) and their parents (68.8; IQR, 63.9-71.4 vs. 96.5; IQR, 95.1-97.9; P < .001). The decrease in health-related QOL was more severe in pediatric patients with VKC/AKC than in those with SAC/PAC (difference, –3.3;95% CI, –5.4 to –1.1; P = .004) and their parents (difference, –3.3;95% CI, –5.4 to –1.1; P = .004) and their parents (difference, –4.3; 95% CI, –7.1 to –2.1; P < .001). In the AC group, a higher corneal fluorescein staining score was linked to lower QOL in pediatric patients (β, –1.16; 95% CI, –1.80 to –0.52; P = .001); higher corneal fluorescein staining scores (β, –1.12; 95% CI, –1.74 to –0.50; P = .001) and multiple clinical consultations (β, –3.96; 95% CI, –7.34 to –0.57; P = .02) were linked to lower QOL in parents.

The parents' QOL scores were correlated with their children's QOL scores (correlation coefficient, r = 0.59; P < .001). The authors noted, "Subscores of physical, emotional, social, and especially school functioning were all significantly lower for the pediatric patients with allergic conjunctivitis than for the control persons. Because pediatric patients generally spend most of their time in the school environment, this outcome raises an issue regarding whether pediatric patients have a poorer performance in their education."

The authors concluded that their findings suggest that AC has a negative association with health-related QOL in pediatric patients and their parents, especially in pediatric patients with VKC/AKC or higher corneal fluorescein staining scores.

In an interview, Yi Ning J. Strube, MD, an associate professor of ophthalmology and pediatrics at Queen's University, Kingston, Canada, whose commentary appears in the same issue of JAMA Ophthalmology, stated, "The quality-of-life scores of the children with allergic conjunctivitis were lower than scores in previous studies for children with vision-threatening diseases, such as glaucoma and congenital cataract. This may be because glaucoma and cataracts do not typically cause discomfort even if they impair the patient's vision."

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