Low Vision Quality Of Life Research Articles

Clinical efficacy of a head-mounted device for central vision loss

Central vision loss (CVL) is a major form of low vision that remains inadequately managed worldwide. This study evaluated the clinical efficacy of a novel head-mounted device (HMD), Onyx, designed to enhance visual function and vision-related quality of life for CVL patients. It employs a projection system that enables patients to leverage their residual peripheral vision for environmental awareness. It also integrates artificial intelligence to augment the automatic recognition of text, faces, and objects. In this single-center, prospective cohort study, 41 binocularly low vision patients with CVL were instructed to use Onyx for 4 to 6 h daily over a one-month period. Various metrics were assessed, including near and distance visual acuity (VA), recognition abilities for faces and objects, and the low vision quality-of-life (LVQOL) questionnaire scores, at the start and end of the study. The results showed significant improvements in near VA for 60.98% of the participants, distance VA for 80.49%, and recognition ability for 90.24%. 68.29% of the participants showed significant improvements in the LVQOL scores. Improvement in recognition ability was negatively correlated with baseline recognition ability. Additionally, improvement in the LVQOL scores was correlated with age and the baseline LVQOL score. Overall, the study found that the novel HMD significantly improved visual function and vision-related quality of life for low vision patients with CVL, highlighting the potential benefits and the need for further evaluation of such devices.

MANAGEMENT APPROACH OF LOW VISION IN RETINITIS PIGMENTOSA: WHAT SHOULD WE DO?

Introduction : Retinitis pigmentosa is a chronic and progressive disease throughout patient’s life. Management low vision in retinitis pigmentosa patients are to maximize their remaining vision and provision of visual aids, it can be financial dan social burden.
 Case Illustration : A 56-year-old man came with blurred vision in his both eyes for 12 years. The patient had cataract surgeries and IOLs implantation in 2022. Ophthalmologic examination revealed the right eye was 4/40 and the left eye was 3/60. Funduscopic examination revealed the bone spicule appearance, blood vessel attenuation, and waxy disc pallor in both eyes. Contrast sensitivity test decreased and Farnsworth hue test showed mild to severe. Humphrey visual field examination showed peripheral visual field defect, therefore patient diagnosed with low vision caused by retinitis pigmentosa with bilateral pseudophakia and his Low Vision Quality of Life was intermediate.
 Discussion : Treatment includes pharmacological treatment with supplementation, optical or non-optical treatment, and rehabilitation. Spectacles clarified distant and near vision with Best Corrected Visual Acuity 6/30 with photochromic lenses, for adapting the light and gave addition lens +5.00 in both eyes. Rehabilitation enhances his head tracking, scanning, and habitual spotting skills. Lighting and typoscope would help his daily reading activities as well.
 Conclusion : Low vision requires several management approach, patient with visual impairment can get low vision aids to optimize his visual function based on his needs. Managing low vision in patient with visual impairment has to be considered from multiple aspects.

Reliability testing of the Persian low-vision quality-of-life questionnaire based on Rasch analysis

Objective: Low-vision quality-of-life (LVQOL) questionnaire was recently translated to Persian. Its model fit and construct validity were assessed by exploratory and confirmatory analysis for adults with visual impairment, before. In this study, we aimed to test the reliability of the Persian LVQOL questionnaire based on Rasch analysis. Methods: Overall, 100 low-vision patients and 100 demographic statue-matched control subjects were participated for evaluating reliability aspects. All the participants were asked to complete the Persian LVQOL questionnaire. The low-vision group was asked to fill out the LVQOL 3 months after rehabilitation to determine how rehabilitation changed the quality of life. Rasch analyses of the survey items were conducted using WINSTEPS. Results: All items fitted the Rasch model. Point-measure correlations values varied from .13 to .70, providing a preliminary indication of adequate construct validity. All factor loadings found more than .4. infit values for all other participants were in the acceptable range. All items obtained infit and outfit MSQ values of < 2.0. Patients’ abilities relative to the item difficulty were analyzed. Item difficulty was estimated and item characteristic curves were included. Sufficient unidimensionality, hierarchical order, and equal interval scaring were obtained. Conclusion: The Persian LVQOL questionnaire was reliable enough and it will be valuable in both clinical practice and research.

Exploratory and confirmatory factor analysis of the Persian version of the low-vision quality-of-life questionnaire

Most of the vision quality assessment questionnaires are in English. None of the low-vision-related quality-of-life questionnaires have been translated or developed in Persian. It will help Persian optometrists and ophthalmologists to assess improvement of visual function and quality of life during their low-vision rehabilitation programs. In this study, we aimed to translate the low-vision quality-of-life (LVQOL) questionnaire in Persian language and apply exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess the construct validity and fit model. Translation and cultural adjustment of the English language LVQOL questionnaire to Persian was undertaken. Overall, 100 low-vision patients were participated to validate and model the assessment questionnaire by both EFA and CFA methods. Complementary EFA and CFA results provide detailed information about item and scale performance of the Persian LVQOL. EFA showed Items 15, 16, and 21 which had factor loadings lower than 0.3. The modified model had the comparative fit index (CFI) and root mean square error of approximation (RMSEA) of 0.89 and 0.06, respectively. The translation, adjustment, and fit analysis of the LVQOL questionnaire into Persian were successful and it will be valuable in both clinical practice and research.

Influence of absorptive tinted filter lenses on contrast sensitivity in healthy participants under three different environmental conditions

Purpose: The present study aimed to analyse the influence of absorptive tinted filter lenses on Contras Sensitivity (CS) in healthy participants under three different environmental conditions. Methods: 10 Healthy qualified volunteers who fulfilled the inclusion/exclusion criteria were recruited: refractive spherical error between +2.00 and -4.00D, refractive cylindrical error less than 1.00 D, Best Corrected Visual Acuity (BCVA) ≥ 1.0 and Low Vision Quality of Life (LVQOF) score ≥ 50. Participants were scheduled for three-session under different environmental conditions where CS was measured with a Pelli-Robson chart with and without five (ML Filters 450, 500, 511, 527 and 550) absorptive tinted filters lenses: 1) indoor, 2) outdoor on a sunny day, 3) outdoor on a rainy day. The filters were always introduced in the same order, from the higher absorption filter (ML Filter 550) to the lower (ML Filter 450). Results between filters and environmental conditions were compared. Results: There was a statistical difference in the CS values obtained with and without a filter in the measurements performed in all environmental conditions (Friedman test: all p < 0.001) with no differences in the pairwise analysis between filters (Wilcoxon test; all ≥ 0.009). There was no statistically difference in the CS values between environmental conditions without filters or with any of the filters (Friedman test: all p ≥ 0.097). Conclusions: The present study found that coloured filter lenses between 450 and 550 nm wavelength absorption had minimal impact on CS in healthy participants.

Clinical performance of a smartphone-based low vision aid

Real-time digital image processing to optimally enhance low vision is now realizable with recent advances in personal computers. This study aimed to evaluate the efficacy of a wearable smartphone-based low vision aid (LVA) with customizable vision enhancement in patients with visual impairment. We recruited 35 subjects with visual impairment and who were literate and cognitively capable. The subjects completed a training session and were provided a smartphone-based LVA for a 4-week use. Visual functions including binocular best-corrected distance, intermediate, and near visual acuities; reading performance (reading speed and accuracy); and facial recognition performance were measured at baseline and after 4-weeks use. All subjects also completed the Low Vision Quality of Life (LVQOL) Questionnaire. Thirty-four subjects (mean age, 43.82 ± 15.06 years) completed the study. Significant improvements in binocular best-corrected distance, intermediate, and near visual acuities were observed after smartphone-based LVA use (all p < 0.001). Reading accuracy and facial recognition performance also improved significantly (p = 0.009 and p < 0.001, respectively), but reading speed did not. LVQOL scores significantly improved after 4 weeks of use in subjects aged < 40 years (p = 0.024), but not in subjects aged ≥ 40 years (p = 0.653). Ocular and non-ocular adverse events were infrequent and resolved when the device was removed. The smartphone-based LVA with customizable vision enhancement could provide clinically significant improvements in the visual function of patients with visual impairment and was generally well tolerated. This study suggests that the smartphone-based LVA would be beneficial for visual rehabilitation.

Outcomes of transcorneal electrical stimulation therapy in the early stages of retinitis pigmentosa.

To investigate the effect of transcorneal electrical stimulation (TES) therapy in patients with retinitis pigmentosa (RP). We performed TES therapy in 21 patients with RP in 12 sessions with 1-week intervals. The following parameters obtained before and after the TES therapy were compared statistically; the best corrected visual acuity (BCVA, logMAR), Ishihara color vision level, multifocal electroretinography (mf-ERG) response, automated visual field (VF) outcome, and the 25-item low vision quality-of-life (LVQOL) questionnaire points. The mean age of patients (6 females; 15 males) was 31.67 ± 9.80 years (20-50 years). While increases in BCVA level, color vision level, mf-ERG response in p1 amplitude of ring 1, and LVQOL questionnaire points were statistically significant, changes in VF test and other mf-ERG responses were not. Twenty of the patients (95.24%) stated that they were satisfied with the TES therapy. No considerable side effect was observed in any patient due to the therapy. The TES therapy may be an effective and safe treatment modality in slowing the RP progression, especially in the early stages of the disease. Longer-term follow-ups in larger patient populations are warranted.

Is the high contrast visual acuity chart a good predictor of improvement in visual acuity with low vision aids?

Purpose:To assess whether the objective improvement seen with HCVA chart using LVAs correlates with subjective improvement in the quality of life as measured on low vision quality of life (LVQOL) questionnaire of such patients.Methods:This was a prospective, consecutive, observational study. Objective improvement in visual function was assessed using LVAs with high contrast LogMAR visual acuity chart for near and distance. Subjective improvement for distance was assessed using LVQOL score for “distance mobility and lighting”, whereas for near it was assessed using the LVQOL score for “near and fine work”. A total of 46 patients completed one follow-up after low vision trial and were included in the study.Results:Improvement in objective visual acuity was highly significant for both near and distance (P < 0.001) with LVAs. LVQOL score improved from 65.85 to 76.83 after one of using low vision aids (P < 0.001). The improvement in LVQOL score for distance and mobility was also highly significant (2.55; P < 0.001); and so was for near and fine work (5.89; P < 0.001). However, Spearman rank correlation coefficient showed no correlation between improvement in visual acuity for distance and LVQOL score improvement for distance (rs = –.086; P = 0.57). For near also, improvement in acuity did not correlate with the LVQOL score improvement for near and fine work (rs = 0.036; P = 0.81).Conclusion:No statistical correlation was observed between the improvements measured by objective HCVA charts and subjective improved as perceived by the patient after use of low vision devices.

Assessment of quality of life, mental health and ocular morbidity in children from schools for the blind in North-East India.

Purpose:The aim of this study was to describe causes of severe visual impairment and blindness (SVI/BL), and assess the mental health and quality of life of children in schools for the blind in North-East India in two phases.Methods:A total of 515 children were examined in 17 schools for the blind in the first phase of study across eight states in North-East India, 6 in Assam, 2 each in Meghalaya, Manipur, Mizoram, and Tripura, 1 each in Arunachal Pradesh, Nagaland, and Sikkim. WHO/PBL eye examination record was used to document findings. In the second phase of study, mental health and quality of life were objectively measured using depression anxiety stress scales (DASS) and low-vision quality of life (LVQOL) questionnaires in 442 children.Results:Approximately 3.1% of children had SVI and 71.84% of children were blind. Anatomical sites of SVI/BL were the whole globe in 44.85%, cornea in 17.66%, and retina in 11.65% of children. The underlying cause of visual loss was undetermined in 55% of children. Hereditary pattern was observed in 1.35% of cases. Approximately 74.94% of children were either blind or severely visually impaired since birth. DASS score revealed that 56.56% of children manifested some levels of anxiety and stress while 85.52% had some reduction in quality of life.Conclusion:A large significant number of these children suffered from potentially preventable and/or treatable cause of SVI/BL. Though nonvisual factors such as physical and mental health were strong predictors of quality of life, this study proves that visual impairment also plays a considerable role in one's quality of life in a population with low vision.

Effects of transitional care on the QOL and compliance of patients with glaucoma

Objective To explore the effects of transitional care on the quality of life (QOL) and compliance of patients with glaucoma. Methods Totally 100 cases of patients with glaucoma from Ophthalmology of Shanghai General Hospital of Shanghai Jiao Tong University were selected from October 2014 to October 2015. By simple sampling method, patients were divided into the experimental group (patients admitted in odd-number week) and the control group (patients admitted in even-number week) with 50 cases in each group. Patients in the control group were given routine education and discharge guidance, and they went to the routine clinics for return visit; patients in the experimental group were given transitional care, education and discharge guidance based on health education handbook, in addition, two telephone follow-up and two outpatient follow-up were took at one month and three months after discharge. Chinese low vision quality of life (CLVQOL) scale, compliance scale and disease-related knowledge questionnaire were used to investigate patients' situation. The QOL, compliance and master degree of disease-related knowledge of patients before and after intervention were compared. Results The scores of CLVQOL of patients in two groups at different time-points were statistically significant different (P 0.05) . The RAM scores of patients in two groups at different time-points were statistically significant different (P>0.05) . The differences of RAM score between two groups were statistically significant (P 0.05) . After admission, there was no significant difference in the scores of disease-related knowledge questionnaire between two groups (P>0.05) ; before discharge, the total score of disease-related knowledge questionnaire and the scores of risk factors, susceptible population, treatment methods, precautions between two groups were statistically significant different (P<0.05) . Conclusions Transitional care intervention can improve the compliance of patients with glaucoma after discharge, as well as the QOL of patients. Key words: Glaucoma; Quality of life; Transitional care; Compliance

The effect of intrinsic motivation on self-efficacy and quality of life for low vision patients

Objective To investigate the effect of self-management program on low vision patients and the role of intrinsic motivation. Methods A total of 160 low vision patients were assigned into 2 groups by random digits table method with 80 cases each. The control group was given routine doctor's advice and health education,and the observation group was given a self-management program guided by well trained medical personnel on the basis of the control group.The General Self-efficacy Scale (GSS) and Chinese-version Low Vision Quality Of Life questionnaire (CLVQOL) was conducted before and after intervention. The patients' intrinsic motivation also was evaluated by Intrinsic Motivation Inventory (IMI) after intervention. Results The total score and scores of interest/fun, inner selectivity, subjective ability and stress/strain dimensions of IMI were (62.25±3.74), (18.43±3.67), (16.13±1.53), (16.05±7.34), (11.64±2.74) points、in observation group and(50.24±4.32), (13.53±2.78), (13.67±1.75), (13.52±2.42), (9.52±1.77) points in control group, and there were significant differences (t=5.813-18.800,P <0.05). The scores of GSS and CLVQOL in observation group after intervention were (27.49±3.41), (64.30±7.04) points, which were higher than those in control group:(16.54±2.25), (34.86±3.99) points, and there were significant differences (t=23.973, 32.540,P <0.05). After intervention,the total score and interest/fun, inner selectivity, subjective ability and stress/strain dimensions of IMI in observation group were positively associated with the score of GSS(r =0.663-0.739,P <0.05). The total score of IMI was positively associated with the total score of CLVQOL(r=0.765,P <0.05). In addition, a positive association was observed between the total score and each dimension of CLVQOL and inner selectivity, subjective ability and stress/strain dimensions of the IMI(r=0.661-0.765,P <0.05). Conclusions A self -management program can improve low vision patients' self-efficacy and quality of life, intrinsic motivation is the important factor influencing the effect of self-management program. Key words: Vision, low; Quality of life; Self-management; Intrinsic motivation; Self-efficacy

α-Lipoic Acid Treatment Improves Vision-Related Quality of Life in Patients with Dry Age-Related Macular Degeneration.

Dry form of age-related macular degeneration (AMD) constitutes 90% of AMD cases, and it is characterized by the formation of drusen under the retina and the slow breakdown of the light-sensing cells in the macula, which causes a gradual loss of central vision. Since oxidative stress is involved in the pathogenesis of dry AMD, α-lipoic acid (LA) with antioxidant properties was selected, and its effect on anti-oxidative markers and visual quality in patients with dry AMD was assessed. A total of 100 dry AMD patients (60-83 years old) were randomly assigned to LA treatment group (n = 50) and placebo control group (n = 50). We measured the serum superoxide dismutase (SOD) activity, an important marker of antioxidant defense, best-corrected visual acuity (BCVA), contrast sensitivity, and Chinese-Version Low Vision Quality of Life (CLVQOL) before and after LA or placebo intervention. Pearson correlation coefficients were calculated to explore the relationship between contrast sensitivity values and CLVQOL scores. There was a statistically significant increase in serum SOD activity after LA intervention. The CLVQOL score was improved significantly after LA treatment. The contrast sensitivity measured at middle and low spatial frequency was significantly higher after LA treatment. CLVQOL scores were positively correlated with contrast sensitivity at low spatial frequency (3 cyc/degree) in LA-treated group. These results indicate that LA treatment improves vision-related quality of life in patients with dry AMD probably by increasing antioxidant activity. Thus, LA can be regarded as a promising agent for the treatment of AMD.

Cataract surgery in patients with bilateral advanced age-related macular degeneration: Measurement of visual acuity and quality of life

To measure the change in visual acuity and vision-related quality of life in patients with both age-related cataract and bilateral age-related macular degeneration (AMD) after cataract surgery. Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, China. Prospective case series. Patients with age-related cataract and bilateral advanced AMD who were diagnosed and treated between January 2006 and January 2012 were enrolled. The patients had successful phacoemulsification with foldable posterior chamber intraocular lens implantation. The corrected distance visual acuity (CDVA) and vision-related quality of life measured by the Chinese-version Low Vision Quality of Life (CLVQOL) questionnaire were collected. The Wilcoxon signed-rank test was used to compare the differences. Binary logistic regression analysis was performed to explore potential factors associated with the change in CLVQOL scores. Sixty eyes of 51 patients were included. The CDVA improved significantly (median difference 0.30 logMAR; range 0 to 1.38 logMAR; P < .001). The CLVQOL composite scores and the 4 subscale scores improved significantly (all P < .001). A greater increase in the CLVQOL scores was associated with inferior preoperative logMAR CDVA in the more severely affected eye (regression coefficient 3.36; P < .001). Cataract surgery improved visual acuity and the vision-related quality of life in patients with both age-related cataract and bilateral advanced AMD. Thus, it is beneficial for patients with coexistent advanced AMD to have cataract surgery. No author has a financial or proprietary interest in any material or method mentioned.

Effectiveness of low vision services in improving patient quality of life at Aravind Eye Hospital.

Context:In India, where the heavy burden of visual impairment exists, low vision services are scarce and under-utilized.Aims:Our study was designed to survey the effectiveness of low vision exams and visual aids in improving patient quality of life in southern rural India.Subjects and Methods:The low vision quality of life (LVQOL) questionnaire measures vision-related quality of life through 25 questions on a Likert scale of 0–5 that pertain to (1) mobility, distance vision, and lighting; (2) psychological adjustment; (3) reading and fine work; and (4) activities of daily living. This tool was translated into Tamil and verbally administered to 55 new low vision referral patients before their first visit at the low vision clinic at Aravind Eye Hospital. Low vision aids (LVAs) were prescribed at the discretion of the low vision specialist. 1-month later, the same questionnaire was administered over the phone.Results:About 44 of 55 low vision patients completed baseline and follow-up LVQOL surveys, and 30 normal vision controls matched for age, gender, and education were also surveyed (average 117.34 points). After the low vision clinic visit, the low vision group demonstrated a 4.55-point improvement in quality of life (from 77.77 to 82.33 points, P = 0.001). Adjusting for age, gender, and education, the low vision patients who also received LVAs (n = 24) experienced an even larger increase than those who did not (n = 20) (8.89 points, P < 0.001).Conclusion:Low vision services and visual aids can improve the quality of life in South Indian rural population regardless of age, gender, and education level. Thus, all low vision patients who meet the criteria should be referred for evaluation.

The impact of attention training on children with low vision: a randomized trial

The purpose of this study was to show the effectiveness of a 6-week attention training program on the cognition, quality of life (QOL), and activities of daily living in children with low vision. Materials and methods: Included in this study were 20 children with low vision, aged 7-12 years. The children were divided into 2 groups. While the first group (n = 10) participated in a 6-week Pay Attention© training program 3 times a week for 30 min, the second group (n = 10) was the control. Before and after the program, all of the participants were evaluated using a modified child Mini Mental State Examination (MMSE), the Northwick Park Index of Independence (NPI), and the low vision QOL (LVQOL) questionnaire. Results: After 6 weeks, while significant differences in the outcome measurements were observed in the trained children (P < 0.05), the children in the control group had no significant differences (P > 0.05). Some differences between the groups were significant in favor of the trained children (P < 0.05). In the trained children, significant differences were found in terms of the MMSE, NPI, and LVQOL (P < 0.05). Conclusion: The results obtained from this study show that the attention training program improves cognitive function, independence in activities of daily living, and the QOL of children with low vision.

Applying Multilevel Item Response Theory to Vision-Related Quality of Life in Dutch Visually Impaired Elderly

Instead of applying the usual longitudinal methods to assess the outcome of low-vision rehabilitation services in terms of vision-related quality of life, a three-level Item Response Theory (IRT) method was proposed. The translated Vision-Related Quality of Life Core Measure (VCM1) and Low Vision Quality Of Life (LVQOL) questionnaires were used in a nonrandomized follow-up study among elderly patients (n = 296) referred to two different low-vision rehabilitation services in the Netherlands. Factor analysis was performed on the matrix of polychoric correlations to investigate (uni-)dimensionality and to prepare both questionnaires for the multilevel IRT analyses. A statistical model, which was characterized by a graded response model for rating scales, was developed. Threshold and item difficulty parameters and group by time-specific mean fixed effects were estimated. Random individual effects were predicted. Measurement invariance across occasions was tested. The VCM1 and the LVQOL "reading and fine work" dimension showed item parameter drift. In the multidisciplinary rehabilitation center patients, deterioration was found on the "mobility" dimension after 1 year and improvement was found on "adjustment" and "visual (motor) skills" after 5 months (p < 0.05). Patients in both low-vision services showed improvement on the "reading small print" subscale at both follow-up time points (p < 0.05). Except for improvement in "reading small print," low-vision rehabilitation services did not seem to contribute substantially to any other dimensions of vision-related quality of life. The results showed a change in only a limited number of individual patients. However, with regard to the field of low-vision rehabilitation, the proposed IRT method seemed to be successful in the follow-up of individuals. IRT specific software was unnecessary. The data did not have to be complete and the use of cumulative logits made the proposed IRT method an economical and efficient approach. Because of item parameter drift, the VCM1 was difficult to interpret. The use of multilevel IRT models with longitudinal data and dependent observations is recommended.

Research on the Quality of Life of Low Vision Patients

Purpose: To Carry out a low vision quality of life questionnaire and to evaluate subjective quality of life of low-vision patients. Methods: The subject were 250 patients whose visual acuity was between hand motion and 0.3 among the patients at our clinic. The normal control group included 60 patients. After a review of the literature, we selected a useful questionnaire to assess quality of life in low vision patients and translated the questionnaire into Korean. The questionnaire used had 25 items concerning low vision and each question was multiple-choice, and the sum of the total points was used to assess of the quality of life. Results: The range of scores was from 0 to 125 points (the higher the score, the higher the quality of life). Fifty-one patients among 250 patients in the low vision group replied to our questionnaire. Fifty patients among 60 patients in the control group replied. The average low vision quality of life (LVQOL) score for patients with low vision (67.3±26.7) was significantly lower than the average score of those with normal vision (114±9.72). There was no statistically significant difference between the average score of patients questioned by mail versus telephone Conclusions: The score of low vision patients was significantly lower than that of the control group, so this questionnaire can be applied to low vision patients specifically to evaluate quality of life. Optimally, the the questionnaire shoud be administered before and after the low vision consultation. The comparision of prerehabilitation score with postrehabilitation score might be helpful to evaluate the quality of life in a post rehabilitation state.

Evaluation of Cross-sectional and Longitudinal Construct Validity of Two Vision-related Quality of Life Questionnaires: The LVQOL and VCM1

The Low Vision Quality of Life (LVQOL) questionnaire and the Vision-related Quality of Life Core Measure (VCM1) are two of the many vision-related quality of life (QOL) questionnaires that have been developed in recent years. Although psychometric properties of the LVQOL and VCM1 compare well with other vision-related QOL questionnaires, construct and longitudinal validity have not been assessed (adequately). The purpose of this study was to examine the cross-sectional and longitudinal construct validity of these questionnaires by testing specific pre-specified hypotheses about the relations of these questionnaires with other measures. The percentage of hypotheses regarding the cross-sectional construct validity that were refuted for the LVQOL was 22% for the basic aspects of vision subscale, 50% for the mobility subscale, 39% for the adjustment subscale and 17% for the reading and fine work subscale. For the VCM1 this percentage was 57%. For the longitudinal construct validity the percentage of hypotheses that were refuted ranged from 33 to 75% for the LVQOL subscales and was 50% for the VCM1. In conclusion, cross-sectional construct validity was satisfactory for the LVQOL subscales, but seemed poor for the VCM1. In addition, the longitudinal validity of these scales was poor to moderate.

Changes to the subscales of two vision-related quality of life questionnaires are proposed

Background and Objective Psychometrically sound questionnaires for the assessment of vision-related quality of life (QOL) are scarce. Therefore, the objective was to further validate two vision-related QOL questionnaires in a Dutch population of visually impaired elderly. Methods A total of 329 visually impaired older persons referred to low vision services completed the low vision QOL (LVQOL) and Vision-Related Quality of Life Core Measure (VCM1) questionnaires at baseline, after 1–4 weeks (retest), and after 5 months. Confirmatory factor analyses were performed on baseline data. The smallest detectable change (SDC) was assessed, based on the standard error of measurement (SEM). Change scores between the baseline and 5 months follow-up data were related to a general transition question to assess the minimal important change (MIC). Furthermore, the MIC was related to the SDC, to examine whether the MICs were detectable beyond measurement error. Results The original factor structures could not be confirmed. After omitting items and remodeling, adequate fits were obtained. SDCs comprised at least one quarter of the scale for all scales and subscales on the individual level and exceeded the MICs on every occasion. Conclusion We propose MICs of 5–10 points for the scales and subscales of the LVQOL and VCM1. The questionnaires are not useful in the follow-up of individual patients.

Implementation methods for vision related quality of life questionnaires

AIMTo determine the most reliable and consistent method and time interval over which to implement a vision impairment quality of life assessment tool.METHODS117 patients with low vision aged 9–101 years...