Pediatric uveitis:EYE-Q and metrics beyond visual acuity

Pediatric uveitis is an inflammatory ocular disease that can lead to sight-threatening complications.Pediatric patients have distinct challenges in the diagnosis and management of uveitis,secondary to difficulties in performing ophthalmic examinations in young children,delayed diagnosis due to lack of adherence with recommended screening schedules,medication side-effects,and increased burden of disease into adulthood.Measurement of outcomes in pediatric uveitis has traditionally relied upon the ophthalmic examination and general quality of life(QOL)measures.However,the ophthalmic examination does not take into account the impact of uveitis on a child’s QOL and general QOL measures do not adequately assess the specific effects of vision.Several vision-related quality of life(VR-QOL)instruments have been used to measure outcomes in both adults and children including:the National Eye Institute Visual Function Questionnaire(NEI VFQ-25),Vision-related Quality of Life of Children and Young People(VQoL_CYP),the Children’s Visual Function Questionnaire(CVFQ),and the Effect of Youngsters’Eyesight on Quality of Life(EYE-Q).However,the NEI VFQ-25 is not a valid or applicable measure in children,and the VQoL_CYP and CVFQ are not uveitis specific and may not characterize disease specific burdens.The EYE-Q is the only uveitis-specific pediatric questionnaire that measures visual functioning and VR-QOL in 5-18 years old children and adolescents with uveitis.It has been shown to be a valid and reliable assessment tool in several cohorts of children with uveitis.A comprehensive assessment of the impact of uveitis on a child that includes a vision-specific measure,such as the EYE-Q,allows for better understanding of the true burden of uveitis in children.For this review,we describe traditional outcome measures in uveitis studies,general QOL measures and vision-specific measures in adults and in children.