{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T15:15:01Z","timestamp":1790349301657,"version":"4.1.0"},"reference-count":49,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2022,5,30]],"date-time":"2022-05-30T00:00:00Z","timestamp":1653868800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ophthalmic Physiologic Optic"],"published-print":{"date-parts":[[2022,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To identify the factors affecting the quality of life (QoL) in adults with keratoconus, using the disease\u2010specific Keratoconus Outcomes Research Questionnaire (KORQ).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross\u2010sectional study, 574 patients with keratoconus completed the 29\u2010item KORQ (18\u2010item activity limitations and 11\u2010item symptoms subscales) and demographic information. Based on mean corneal curvature to grade keratoconus severity, participants were categorised into four groups: mild &lt;48 dioptres [D]; moderate: 48 to 53 D; advanced: 54 to 55 D and severe: &gt;55D. Rasch analysis was used to assess the psychometric properties and to score the KORQ. Multivariable regression was performed to determine the independent impact of age, sex, laterality, severity and duration of keratoconus, education, employment status and mode of treatment for keratoconus on activity limitations and symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean (SD) age was 24.5 (5.1) years. 304 (53%), 160 (28%), 26 (4%) and 84 (15%) belonged to keratoconus groups 1, 2, 3 and 4, respectively. Rasch analysis demonstrated the \u2018activity limitations\u2019 and \u2018symptoms\u2019 KORQ subscales to possess good psychometric properties. Statistically significant associations were found between activity limitation score and the following measures: visual acuity (VA) in the better\u2010seeing eye (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u22120.10,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01); VA in the worse\u2010seeing eye (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u22120.09,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.04) and ocular aberrations (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u22120.13,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.008) in the worse\u2010seeing eye. Statistically significant associations were also found between symptoms score and mean corneal curvature in the better\u2010seeing eye (\n                      <jats:italic>r<\/jats:italic>\n                      \u00a0=\u00a0\u22120.10,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.02). In regression models, female sex was associated with 21% worse symptom score than male (\u03b2\u00a0=\u00a0\u22120.33, 95% CI, \u22120.09, \u22120.59,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.01) and working people experienced clinically and statistically significantly greater trouble from symptoms compared to those not working (\u03b2 =0.44, 95% CI, 0.17, 0.70,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>People with keratoconus have poorer QoL in terms of activity limitations if they have poorer VA and greater wavefront aberrations, and in terms of symptoms if they are female and employed.<\/jats:p>\n                  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