Abstract
BackgroundThe use of self-report questionnaires to substitute for visual acuity measurement has been limited. We examined the association between visual impairment and self reported visual function in a population sample of older people in the UK.MethodsCross sectional study of people aged more than 75 years who initially participated in a trial of health screening. The association between 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ) scores and visual impairment (defined as an acuity of less than 6/18 in the better eye) was examined using logistic regression.ResultsVisual acuity and NEI-VFQ scores were obtained from 1807 participants (aged 77 to 101 years, 36% male), from 20 general practices throughout the UK. After adjustment for age, gender, practice and NEI-VFQ sub-scale scores, those complaining of poor vision in general were 4.77 times (95% CI 3.03 to 7.53) more likely to be visually impaired compared to those who did not report difficulty. Self-reported limitations with social functioning and dependency on others due to poor vision were also associated with visual impairment (odds ratios, 2.52, 95% CI 1.55 to 4.11; 1.73, 95% CI 1.05 to 2.86 respectively). Those reporting difficulties with near vision and colour vision were more likely to be visually impaired (odds ratios, 2.32, 95% CI 1.30 to 4.15; 2.25, 95% CI 1.35 to 3.73 respectively). Other NEI-VFQ sub-scale scores were unrelated to measures of acuity. Similar but weaker odds ratios were found with reduced visual acuity (defined as less than 6/12 in the better eye). Although differences in NEI-VFQ scores were small, scores were strongly associated with visual acuity, binocular status, and difference in acuity between eyes.ConclusionNEI-VFQ questions regarding the quality of general vision, social functioning, visual dependency, near vision and colour vision are strongly and independently associated with an objective measure of visual impairment in an elderly population.
Highlights
The use of self-report questionnaires to substitute for visual acuity measurement has been limited [9], the National Eye Institute Visual Function Questionnaire (NEI-VFQ) has been used in adult populations to show that those with visual impairment have lower scores compared to those without reduced visual acuity [10,11]
We have examined the association between responses to the NEI-VFQ and objective measures of visual impairment
This study showed that self-reported problems on the NEI-VFQ are associated with visual impairment, problems with some domain scores were more strongly associated with visual impairment than other domain scores
Summary
The use of self-report questionnaires to substitute for visual acuity measurement has been limited. The shortened questionnaire has been validated and used to show that those with ocular disease and accompanying visual impairment have lower scores compared to a reference group without ocular disease or visual impairment [6,7,8]. The use of self-report questionnaires to substitute for visual acuity measurement has been limited [9], the NEI-VFQ has been used in adult populations (aged 40 years or more) to show that those with visual impairment have lower scores compared to those without reduced visual acuity [10,11]. Use of the NEI VFQ in non-US populations is limited, especially amongst older populations who are likely to experience higher levels of visual difficulties than younger age groups
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