Vision-related Daily Activities Research Articles

Vision-Related Activities among Glaucoma Patients in Onitsha Nigeria

Objective: To evaluate performances of different task by Primary open angle glaucoma (POAG) patients at Guinness Eye Centre Onitsha Nigeria. Materials and methods: POAG patients underwent a modified culturally relevant five items of the Activities of Disability Related to Vision (ADREV) tasks. These tasks were recognizing facial expression, detecting motion, locating objects, placing pegs into different sized holes and matching socks. The score ranged from 0 to 7(0=inability to carry out any task, 7=task carried out effortlessly with grades in between scores based on ease of carrying out task). Glaucoma severity was also assessed. Results: Two hundred and four patients with mean age of 61.0 years; 46.1% males and 53.9% females participated in this study. The total mean score of the 5 tasks carried out was 26.6 ± 9.9SD; range of 0-35. The ratings for the individual tasks were: motion detection 6.21 ± 1.8; placing pegs 5.77 ± 2.1; object location 5.39 ± 2.2; facial expression 4.73 ± 2.1 and matching socks 4.49 ± 2.5. Patients aged ≥ 60 years had more advanced glaucomatous damage and greater difficulty performing the task (p=0.01) Conclusion: Older age and more glaucomatous damages were associated with poor ADREV performance. Matching of socks and identification of facial expressions were the most tasks. Older glaucoma patients and those with advanced disease require support for vision-related activities of daily living.

Visual outcomes and patient satisfaction after bilateral implantation of a new trifocal diffractive intraocular lens

PurposeTo assess the visual outcomes, patient satisfaction and spectacle independence following implantation of new diffractive trifocal intraocular lenses. Setting2 centers (university-based practice and a private practice set up). Patients and methodsProspective nonrandomized study in which 74 AT LISA TRI 839MP and 8 AT LISA TORIC TRI 939MP IOLs implanted bilaterally in 41 patients following either cataract extraction or refractive lensectomy, follow-up was done at 1st, 2nd and 3rd months to assess the visual and refractive outcomes. Also, a questionnaire was used to assess patient satisfaction, spectacle independence and photic phenomena after the surgery. ResultsMean uncorrected monocular distance decimal visual acuity (UDVA) was preoperatively 0.35. The averages of uncorrected monocular distance/intermediate/near (UDVA/UIVA/UNVA) postoperatively were 0.90/0.87/0.91 at 3 months. 87.5% patients had SE within ±0.50 by the 3rd month. Nearly all the patients were satisfied with the surgical outcome and the reported photic phenomena by some patients were non-disturbing with noticeable high level of patient’s satisfaction by the third month. ConclusionDiffractive trifocal IOLs can provide with satisfactory visual and refractive results along with positive impact on the performance of vision-related daily activities with minimal level of non-disturbing photic phenomena to patients.

Effects of V4c-ICL Implantation on Myopic Patients’ Vision-Related Daily Activities

The new type implantable Collamer lens with a central hole (V4c-ICL) is widely used to treat myopia. However, halos occur in some patients after surgery. The aim is to evaluate the effect of V4c-ICL implantation on vision-related daily activities. This retrospective study included 42 patients. Uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), intraocular pressure (IOP), endothelial cell density (ECD), and vault were recorded and vision-related daily activities were evaluated at 3 months after operation. The average spherical equivalent was −0.12 ± 0.33 D at 3 months after operation. UCVA equal to or better than preoperative BCVA occurred in 98% of eyes. The average BCVA at 3 months after operation was −0.03 ± 0.07 LogMAR, which was significantly better than preoperative BCVA (0.08 ± 0.10 LogMAR) (P = 0.029). Apart from one patient (2.4%) who had difficulty reading computer screens, all patients had satisfactory or very satisfactory results. During the early postoperation, halos occurred in 23 patients (54.8%). However there were no significant differences in the scores of visual functions between patients with and without halos (P > 0.05). Patients were very satisfied with their vision-related daily activities at 3 months after operation. The central hole of V4c-ICL does not affect patients' vision-related daily activities.

Visual Outcomes, Patient Satisfaction and Spectacle Independence with a Trifocal Diffractive Intraocular Lens.

PurposeTo evaluate visual outcomes following implantation of a trifocal diffractive intraocular lens (IOL) and to analyze their correlation with patient satisfaction and ease of performing daily tasks.MethodsThis was a prospective study enrolling 100 eyes of 50 patients undergoing cataract surgery with implantation of trifocal IOL AT LISA tri 839MP. Visual and refractive outcomes were evaluated during a 3-month follow-up. Postoperatively, a questionnaire was used to evaluate patient satisfaction with regard to surgical outcome, spectacle independence, perception of photic phenomena, and ease of performing some vision-related activities.Results A total of 91%, 87%, and 79% of eyes achieved a monocular uncorrected distance, near, and intermediate visual acuity of 0.1 logarithm of the minimum angle of resolution or better, respectively. After the surgery, 96% of the patients could perform their daily activities without problems. The mean spectacle independence scores for reading, doing computer work, and for distance were 10.33 ± 12.47, 5.71 ± 11.90, and 3.92 ± 9.77, respectively (scale: 0 = no spectacles needed; 40 = spectacles always needed). No correlation was found between spectacle independence and visual outcome (-0.101 ≤ r ≤ 0.244, p ≥ 0.087). Mean scores (0 = no symptoms; 40 = strong symptoms) for glare at night, ghost images, and halos were 15.15 ± 12.02, 4.49 ± 7.92, and 13.34 ± 10.82, respectively. No correlation was found between photic phenomena and visual outcome (-0.199 ≤ r ≤ 0.209, p ≥ 0.150). A total of 80% of patients reported satisfaction with the surgery outcome, and 86% would recommend the surgery to friends and family.ConclusionsImplantation of the AT LISA tri 839MP IOL after cataract surgery provides effective visual restoration associated with a minimal level of photic phenomena, a positive impact on the performance of vision-related daily activities, and a high level of postoperative patient satisfaction.

The Correlation Between Glaucomatous Visual Field Loss and Vision-Related Quality of Life

To evaluate the vision-related quality of life (QoL) of glaucoma patients in terms of the correlation between visual field (VF) loss and National Eye Institute Visual Functioning Questionnaire-39 (NEI VFQ-39) survey. A total of 244 glaucoma patients were examined with monocular Humphrey 24-2 central full threshold and Esterman binocular VF tests. Patients were grouped according to their monocular VFs done by Advanced Glaucoma Intervention Study (AGIS) classification and Esterman binocular VF efficiency scores. NEI VFQ-39 was applied for the evaluation of vision-related QoL. NEI VFQ-39 subscales and total scores were evaluated and the highest mean average values were in "color vision" (92.00±16.59) and "social functioning" (90.74±15.98). The lowest mean average values were in "general health" (54.76±18.86) and "general vision" (66.03±17.59). All the subscales except "general health" and "ocular pain" showed positive correlations with the monocular and Esterman binocular VF groupings. Pearson correlation analysis between NEI VFQ-39 subscales and the AGIS VF classification-based groups indicated that the subscales had statistically significant negative correlations except the "general health" (r=-0.151, P=0.018) and "ocular pain" (r=-0.048, P=0.455). The highest correlation with AGIS VF classification was in "driving" (r=-0.477, P=0.001) and "general vision" (r=-0.446, P=0.000) subscales. There was statistically significant correlation between NEI VFQ-39 subscales and Esterman binocular VF groups except "general health" (r=-0.064, P=0.318) and "ocular pain" (r=-0.062, P=0.337). The highest negative correlation was in "distant activities" (r=-0.522, P=0.000) and the lowest negative correlation was in "color vision" (r=-0.416, P=0.000) subscales. The highest correlation between binocular distant and binocular near-visual acuities was in "distant activities" and the lowest correlation was in "role difficulties" subscales. There is statistically significant correlation between the glaucoma patients' VF loss and the vision-related QoL. The evaluation of self-reported vision status in glaucoma patients may be a guide for the rehabilitation of their disabilities in vision-related daily activities.

Dry eye disease in French elderly subjects: the Alienor Study

To describe dry eye disease in French elderly subjects. The Alienor Study is a population-based study on age-related eye disease in 963 residents of Bordeaux (France), aged 73 years or more. Self-reported dry eye disease and use of artificial tears were documented through face-to-face interview. Dry eye symptoms were assessed using the Ocular Surface Disease Index (OSDI) questionnaire and tear film stability by tear break-up time measurements (TBUT). Definite dry eye disease was defined as self-reported dry eye, confirmed by use of artificial tears and/or OSDI greater or equal to 22. Nine hundred and fifteen subjects, with mean age of 80 ± 4 years, returned the OSDI questionnaire. Of these, 271 (29.6%) subjects reported a dry eye disease and 135 (14.7%) were using artificial tears. An OSDI score > 22 was found in 359 (39.2%) subjects and a TBUT < 5 seconds in 335/746 (44.9%) subjects. Overall, definite dry eye affected 21.9% of subjects and was more frequent in women (27.1%) than in men (13.6%). After multivariate adjustment, dry eye disease was also significantly less frequent in subjects with high educational level (odds ratio (OR) = 0.49, 95% confidence interval (CI): 0.31-0.78 for long secondary school) and more frequent in subjects with ocular hypertension (OR = 1.61, 95% CI: 1.02-2.57) and those using anxiolytics (OR = 1.53, 95% CI: 1.02-2.29). This large observational study confirmed the high prevalence of dry eye symptoms among elderly subjects and confirmed some of the previously identified risk factors (in particular female gender and use of anxiolytics).

Keratoconus in Asians: demographics, clinical characteristics and visual function in a hospital‐based population

To describe the demographics, clinical characteristics and visual function of Asian patients with keratoconus managed in a tertiary eye centre. Prospective cross-sectional study. 116 patients with clinically evident or suspected keratoconus (on videokeratography) recruited over 11 months. A standardised interview, full ophthalmic examination, refraction and corneal topography were performed. Visual function was assessed with the VF-14 questionnaire. Demographics, clinical characteristics and visual function. Mean age of our patients was 29.5 ± 9.40 years on enrolment, 62.9% were male, and the ethnic distribution was 60.3% Chinese, 13.8% Malays and 9.5% Indians. Clinically evident keratoconus was present bilaterally in 65 patients (56.0%) and unilateral keratoconus in five patients (4.3%). Five patients (4.3%) had a family history of keratoconus. The majority of patients were managed with contact lenses (60.8%) or glasses (24.5%). Eye rubbing was common (68%) as were asthma (26.3%) and eczema (18.4%). Conical protrusion was the commonest sign (75.3%). The mean cylinder was higher in keratoconus eyes compared with keratoconus suspect eyes (-4.01 vs. -1.27, P < 0.001), and best-corrected visual acuity was poorer (0.19 vs. 0.05, P < 0.001). Unaided visual acuity was significantly worse with increasing age (P = 0.016). On the VF-14, 32% scored 90 or less (out of 100), reflecting difficulties with vision-related daily activities. Our Asian patients with keratoconus had similar demographic and clinical characteristics to patients in Western populations. Even with apparently good visual acuity, some patients still experience substantial impairment in vision-related activities.

Severity of Diabetic Retinopathy and Health-Related Quality of Life: The Los Angeles Latino Eye Study

To assess the impact of diabetic retinopathy (DR) and its severity on health-related quality of life (HRQOL) in a population-based sample of Latinos with type 2 diabetes mellitus (DM). Cross-sectional population-based study, the Los Angeles Latino Eye Study (LALES). We included 1064 LALES participants with DM. We measured HRQOL by the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the Medical Outcomes Study 12-item Short Form Health Survey (SF-12). We assessed DR by masked standardized grading of stereoscopic photographs from 7 standard fields. Severity of DR in eyes was graded using a modified Airlie House classification. The severity scores from each eye were then concatenated to create a single per person grade ranging from 1 (no DR in either eye) to 15 (bilateral PDR). Multiple linear regression analyses were performed to determine the independent relationship between severity of DR and HRQOL after adjusting for covariates. Scores on the NEI-VFQ-25 and SF-12. More severe DR was associated with worse HRQOL scores on all of the NEI-VFQ-25 and SF-12 subscales (P<0.05). Individuals with DR from grade 2 (minimum nonproliferative diabetic retinopathy [NPDR]) through grade 8 (unilateral moderate NPDR) show a modest decline in HRQOL. However, the decline becomes significantly steeper between steps 8 (unilateral moderate NPDR) and 9-15 (bilateral moderate NPDR to bilateral PDR). The domains with the most significant impact were for vision-related daily activities, dependency, and mental health. Greater severity of DR was associated with lower general and vision-specific HRQOL. Persons with bilateral moderate NPDR had the most substantial decrease in quality of life compared with those with less severe DR. The prevention of incident DR and, more important, its progression from unilateral to bilateral NPDR is likely to have a positive impact on a person's HRQOL and should be considered an important goal in management of individuals with DM.

Impact of symptomatic dry eye on vision-related daily activities: The Singapore Malay Eye Study

To examine the impact of symptomatic dry eye on vision-related daily activities. A population-based survey of eye diseases was conducted on 3280 (78.7% response rate) Malay persons aged >or=40 years, who were randomly selected from designated areas in southwestern Singapore. Participants were administered a standardized dry eye questionnaire consisting of six questions on symptoms, a questionnaire on vision-related daily activities, and underwent a comprehensive systemic and ocular examination. Symptomatic dry eye was defined as one or more self-reported symptoms that were frequently present (ranked as often or all the time). Logistic regression method was used to examine the relationship of symptomatic dry eye with difficulty in performing daily activities. In adults without visual impairment, symptomatic dry eye after adjusting for age, gender, and presenting visual acuity was significantly associated with difficulty in vision-related activities such as navigating stairs (odds ratio (OR)=1.96, 95% confidence interval (CI): 1.28-3.00), recognizing friends (OR=1.99, 95% CI: 1.45-2.73), reading road signs (OR=1.87, 95% CI: 1.36-2.57), reading newspaper (OR=1.50, 95% CI: 1.11-2.04), watching television (OR=1.90, 95% CI: 1.26-2.87), cooking (OR=1.94, 95% CI: 1.02-3.71), and driving at night (OR=2.06, 95% CI: 1.32-3.21). Symptomatic dry eye was associated with difficulty in performing vision-dependent tasks, independent of visual acuity and other factors. These findings have public health significance and suggest that the visual dysfunction in dry eye should be further characterized.