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Editors Selection IGR 11-4

Epidemiology: Quality of Life

Comment by Henry Jampel on:

15166 Impact of severity and bilaterality of visual impairment on health-related quality of life, Varma R; Wu J; Chong K et al., Ophthalmology, 2006; 113: 1846-1853

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In their latest analysis from the Los Angeles Latino Eye Study (LALES), a cross-sectional study of vision among an urban, Spanish speaking population, Varma et al. (981) continue to provide us with important information about the ocular health of this increasingly important sector of the United States population. In this investigation they explore the question of whether decreased visual acuity (VA) results in patient reports of decreased function, both related to vision and unrelated to vision. They divide VA into normal (VA > 20/40 Snellen), mildly impaired (20/40 ≥ VA > 20/80), or moderate/severe (20/80 ≥VA). They assess vision related quality of life (QOL) with the National Eye Institute VFQ (NEI-VFQ), and overall quality of life with the Medical Outcomes Study Short Form 12. Their principal findings were that the NEI-VFQ scores were reduced most markedly for bilateral moderate/severe decreases in visual acuity; both were also reduced, but not as much, for bilateral mild decrease and unilateral moderate/severe decrease. The subscales that were most affected were those associated with entities that many would consider critical to well-being-driving, dependency, and distance-related tasks. The authors do not comment on whether different causes of decreased visual acuity affect vision-related quality of life differently. This work has practical implications. For instance, it suggests that removal of a cataract even when the fellow eye has normal vision is likely to lead to improvement in patient-reported vision-related quality-of-life.

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