Vision-related Quality Of Life Questionnaire Research Articles

Prevalence and Impact of Refractive Errors in School-Aged Children: A Cross-Sectional

This cross-sectional study aims to determine the prevalence and patterns of refractive errors among 700 schoolchildren aged 5-15 years in Al-Manara School, Tobruk, Libya. A comprehensive ophthalmic examination will be conducted to assess visual acuity and identify refractive errors. Academic performance will be evaluated by reviewing school records, including grades and standardized test scores. The impact of refractive errors on quality of life will be measured using a validated pediatric vision-related quality of life questionnaire. The study seeks to provide data on the burden of refractive errors and their effects on learning and daily living in this population. We hypothesize that uncorrected refractive errors will be associated with poorer academic achievement and reduced quality of life compared to peers without vision impairment. This research can highlight the need for regular vision screening and provision of spectacles for schoolchildren in Libya. Findings may guide education policy and school health programs to address this treatable cause of impaired classroom performance. The large sample size will allow for analysis of prevalence stratified by key demographics and characterization of the patterns of refractive errors in this geographic setting.

Corneal ulcers and the risk of visual impairment in a matched cohort study in Nepal

PurposeWe estimated the association between corneal ulcer and two outcomes: visual impairment and vision-related quality of life. We investigated for differential effects by rural/urban location. DesignPopulation-based matched prospective cohort study. MethodsWe followed 540 incident corneal ulcer cases identified in a cluster randomized trial in Nepal. Cases were pair-matched to individuals without incident corneal ulcers by age, sex and location using incidence density sampling. Clinical examinations were performed to assess outcomes in both groups after 12 months, which included visual acuity and a modified version of the Hong Kong vision-related quality of life questionnaire. Results392 matched pairs had complete outcome data and were included in the analyses. Median age was 42 years (interquartile range [IQR]: 28, 53) and 63.8 % were female. After controlling for education and occupation, corneal ulcer was associated with an approximately 1-line reduction in visual acuity (0.11 logMAR units, 95 % CI 0.06 to 0.15, P < 0.001), and with an increased risk of low vision/blindness (adjusted risk ratio 1.89, 95 % CI 1.44 to 2.48, P < 0.001). Corneal ulcer was associated with lower vision-related quality of life on the 20-question questionnaire (adjusted mean difference in score -1.69, 95 % CI -2.78 to -0.61, P = 0.002). We were unable to demonstrate effect modification for any outcome by rural/urban status. ConclusionsWe observed worse visual acuity and lower vision-related quality of life among those with incident corneal ulcers compared to those without. The population-based design, which captured the full spectrum of disease, confirms that corneal ulcers are an important cause of vision loss in the general population of Nepal and highlights the need for effective community-based corneal ulcer prevention interventions.

Assessment of the vision-related quality of life (VR-QOL) in patients with watery eyes

Watering from the eyes is one of the common ocular complaints which leads to blurred vision. It has an impact on daily activities and the social life of the individual which is not studied much. Hence, we did this study with the aim to estimate the proportion of watery eye patients in whom the vision-related quality of life (VR-QOL) is affected. We conducted a cross-sectional questionnaire-based study. Patients who complained of watering for more than one month were included. All the patients were asked to fill a VR-QOL questionnaire. We considered VR-QOL status to be affected if the score for any of the activity listed in the questionnaire was more than or equal to one. We assessed the association of this VR-QOL status with various factors like age, gender, laterality, patency of nasolacrimal duct and Munk score. A total of 59 patients participated in our study. The mean age of study participants was 52.6 ± 13.8 years and 31 were males. VR-QOL was affected in 89.8% and blurring of vision was the most common impairment. The effect of gender and age on VR-QOL due to watering was not significant. We found that watering of eyes causes a significant blurring of vision (p value=0.031) and discomfort during outdoor activities (p-value 0.045). : Epiphora has a significant impact on VR-QOL. The lacrimal drainage system is the major cause of watery eyes. It is important to include the functional component in the outcome assessment of epiphora treatment.

Validity and Version of the Vision-related Quality of Life Questionnaire

Background and Objectives: The vision-related quality of life (VRQoL) questionnaire has already been developed. However, some items of these instruments are not suitable for Iranian samples. This study aims to develop the Persian version of this questionaire to evaluate the functional vision of visually impaired Iranian people. Methods: The VRQoL questionnaire was evaluated and 43 items were chosen as an initial questionnaire. Ten visually impaired people were interviewed to express their idea about the position and manner of expressing questions in the questionnaire. Some items were excluded and the remained items were given to 30 patients as well as some visual impairment specialists. Their opinions about the face validity of the questionnaire were used. The content validity of this instrument called the Iranian low vision questionnaire (ILVQ) was evaluated using Lawshe’s content validity ratio. To construct validity, factor analysis was used. Internal reliability was evaluated using Cronbach’s alpha coefficient. Results: The reduction of psychometric items showed that three items should be eliminated and a 32-item questionnaire was produced as an Iranian low vision questionnaire (ILVQ). This local instrument has performance-based (13 items) and self-reported (19 items) sections with a five-point response scale. The psychometric evaluation showed an internal reliability of 96% by Cronbach’s alpha coefficient and an overall reliability and repeatability of 0.96 (P&lt;0.001) by intraclass correlation coefficient (ICC). The test-retest reliability was obtained at 0.94 (P&lt;0.001) to indicate the external reliability and stability of the instrument. Conclusion: This instrument has high validity and reliability, which is a standard tool to assess the quality of life (QoL) among Iranian visually impaired people. Existing questionnaires around the world should be modified to add or remove some items due to advanced technologies.

First-in-Human Gene Therapy Trial of AAV8-hCARp.hCNGB3 in Adults and Children With CNGB3-associated Achromatopsia

To assess the safety and efficacy of AAV8-hCARp.hCNGB3 in participants with CNGB3-associated achromatopsia (ACHM). Prospective, phase 1/2 (NCT03001310), open-label, nonrandomized clinical trial. The study enrolled 23 adults and children with CNGB3-associated ACHM. In the dose-escalation phase, adult participants were administered 1 of 3 AAV8-hCARp.hCNGB3 dose levels in the worse-seeing eye (up to 0.5 mL). After a maximum-tolerated dose was established in adults, an expansion phase was conducted in children ≥3 years old. All participants received topical and oral corticosteroids. Safety and efficacy parameters, including treatment-related adverse events (AEs) and visual acuity, retinal sensitivity, color vision, and light sensitivity were assessed for 6 months. AAV8-hCARp.hCNGB3 (11 adults, 12 children) was safe and generally well tolerated. Intraocular inflammation occurred in 9 of 23 participants and was mainly mild or moderate in severity. Severe cases occurred primarily at the highest dose. Two events were considered serious and dose-limiting. All intraocular inflammation resolved following topical and systemic steroids. There was no consistent pattern of change from baseline to week 24 for any efficacy assessment. However, favorable changes were observed for individual participants across several assessments, including color vision (n=6/23), photoaversion (n=11/20), and vision-related quality of life questionnaires (n=21/23). AAV8-hCARp.hCNGB3 for CNGB3-associated ACHM demonstrated an acceptable safety and tolerability profile. Improvements in several efficacy parameters indicate that AAV8-hCARp.hCNGB3 gene therapy may provide benefit. These findings, with the development of additional sensitive and quantitative endpoints, support continued investigation.

Effects of rigid gas permeable contact lens on morphological parameters and vision-related quality of life in keratoconus patients.

To evaluate the effect of rigid gas permeable contact lens (RGP-CL) on corneal morphological parameters and vision-related quality of life in keratoconus (KC) patients. Totally 57 eyes of 30 KC patients who were followed-up for more than two years, including 17 RGP wearers (32 eyes) and 13 non-wearers (25 eyes) were retrospectively analyzed. Initial medical history and corneal topography were collected at baseline. Corneal topography, corneal aberration, optical coherence tomography, and vision-related quality of life questionnaires were performed at the last follow-up. According to corneal topography, increase of the flattest keratometric values was higher in RGP wearers than in non-wearers (P=0.038). The morphological parameters, including symmetry index of front corneal curvature (P=0.004) and Baiocchi-Calossi-Versaci index front (P=0.047), were lower in RGP wearers than in non-wearers. Vertical coma was smaller in RGP wearers than non-wearers in 3.0, 5.0, 6.0, and 7.0 mm pupil diameters, respectively (P<0.05). The environmental triggering domain of ocular surface disease index was worse in RGP wearers as compared to non-wearers (P=0.003). At the last follow-up, there were no significant differences in constituent ratios of KC progression, corneal thickness topography, epithelial thickness topography, morphological parameters of corneal topography, and other questionnaire scores between the two groups (all P>0.05). Long-term use of RGP does not worsen KC but may cause corneal epithelial remodeling to increase symmetry of corneal anterior surface, reduce corneal vertical coma and improve visual quality. However, RGP wearing causes a slight decrease in vision-related quality of life. The occurrence of ocular surface symptoms is mainly associated with environmental triggering factors.

Factors Affecting Long-Term Compliance with Rigid Gas-Permeable Contact Lens Wear in Patients with Keratoconus.

The purpose of the study was to investigate the factors affecting long-term compliance with rigid gas-permeable contact lens (RGPCL) wear in patients with keratoconus (KC). A total of 189 patients with KC (374 eyes) were included in the study, and were divided into two groups: the compliant group and the non-compliant group. Corneal topographic measurements, refractive results, and RGPCL parameters were compared between the two groups. A vision-related quality of life questionnaire was completed by all of the patients. The results demonstrated that patients diagnosed with bilateral KC were more compliant with RGPCL wear than patients diagnosed with unilateral KC (p = 0.0167). There were no significant differences between the compliant and non-compliant groups in terms of their corneal topographic measurements, refractive results, RGPCL parameters, or corneal cross-linking surgery history (all p > 0.05). In contrast, KC patients’ subjective experience with RGPCL wear—including visual acuity (p = 0.006), overall satisfaction (p < 0.001), quality of life (p < 0.001), and good adaptation during the short-term (p < 0.001)—had a significant effect on the long-term compliance with RGPCL wear. In conclusion, patients’ subjective experiences, rather than their ocular biometrics, significantly influence their long-term compliance with RGPCL wear.

Validation of a Filipino Translation of a Vision-related Quality of Life Questionnaire

Objectives. This study aims to translate the WHO VF-20 questionnaire into Filipino (Tagalog) and validate the translated questionnaire. Methods. Patient information such as age, sex, educational background, and employment was recorded. Preoperative uncorrected and best-corrected visual acuities were also obtained. The VF-20 questionnaire was first translated into Filipino by an independent translator. The Filipino version was then back-translated to English by another translator. The original VF-20 questionnaire and back-translated English version were compared and checked for discrepancies. The Filipino questionnaire was then pretested on 60 participants who met the inclusion and exclusion criteria. Cronbach's alpha coefficient was determined. Results. No major discrepancies in content were noted between the original VF-20 and the back-translated version. Cronbach's alpha coefficient was more than 0.9 for all the 20 items when each item was removed. The translated questionnaire shows high internal consistency (Cronbach's alpha coefficient, 0.9144). Conclusion. The Filipino version of the WHO VF-20 is a valid tool to assess vision-related quality of life in patients with visual impairment due to cataract. The questionnaire can be used as a tool for clinical evaluation, monitoring response to treatment, and future research studies.

Prevalence of Presbyopia, Near-spectacle Use and Near Vision Spectacle Coverage among Cosmetologists in Mushin Local Government Area of Lagos State, Nigeria.

To determine the prevalence of presbyopia, near vision spectacle use, and near vision spectacle coverage among cosmetologists in Mushin Local Government Area of Lagos State with the view of creating awareness, improving productivity and quality of life. This was a descriptive cross-sectional study, conducted among 251 cosmetologists aged ≥ 30 years. All participants had a standardized protocol including visual acuity assessment (distance and near), anterior and posterior segment examinations, and refraction. Spectacle usage, work, productivity impact, and near vision-related quality of life (NVQoL) information were obtained with the 12-item Near Vision-Related Quality of Life Questionnaire, the Spectacle Usage section of the World Health Organisation (WHO) Spectacle and Work Productivity Questionnaire. Data obtained was analysed using Statistical Package for Social Sciences version 23 (IBM Corp. Armonk, NY). Two hundred and fifty-one cosmetologists were studied with a male to female ratio of 1:6.4 and overall mean age of 43.9 ± 6.5 years. The prevalence of presbyopia was 67.3% and the unmet need was 51.3%. Eighty-four percent of presbyopic participants reported severe difficulty with their NVQoL compared to 16% of non-presbyopes. There was a statistically significant association between uncorrected presbyopia and reduced NVQoL (P < 0.001). This study demonstrated a relatively high prevalence of presbyopia, high unmet need, and a significant reduction in the near vision-related quality of life. This indicates the need for improved access to refractive services and spectacles among this group of artisans in whom near vision plays an indispensable role.

Vision-related quality-of-life in pediatric primary brain tumor patients.

Purpose:Brain tumors are the leading cause of death from childhood cancer. Although overall survival has improved due to earlier detection, better therapies, and improved surveillance, visual dysfunction and impaired vision-related quality-of-life (VR-QOL) are often unrecognized in children. This project investigated VR-QOL in pediatric brain tumor patients.Methods:We evaluated visual impairment and quality-of-life (QOL) in a quality improvement project at one tertiary care center. Patients ≤18, greater than 6 months from diagnosis of brain tumor, excluding intrinsic anterior visual pathway tumors, underwent standardized neuro-ophthalmologic examination. Health-related QOL (HR-QOL) [PedsQL Brain Tumor Module] and VR-QOL questionnaires [CVFQ (Children’s Visual Function Questionnaire) in children ˂8, and EYE-Q in children 8–18] were obtained from patients and parents.Results:Among 77 patients, craniopharyngiomas (n=16, 21%) and astrocytomas (n=15, 20%) were the most common tumors. Among 44/77 (57%) visually impaired children, 7 (16%) were legally blind. Eye-Q median score was 3.40 (interquartile range 3.00–3.75), worse than average scores for normal children. Eye-Q score decreased 0.12 with every 0.1 increase in logMAR visual acuity [p<0.001]. Patients who were legally blind had a significantly lower Eye-Q score than those who were not (0.70 vs. 3.44 [p<0.001]). Cognitive HR-QOL scores decreased 1.3 for every 0.1 increase in logMAR visual acuity [p=0.02].Conclusions:Pediatric brain tumor patients’ vision, HR-QOL, and VR-QOL were often severely affected even when tumors were considered cured. Visual acuity and legal blindness correlated with VR-QOL. Systematic neuro-ophthalmologic examinations in pediatric primary brain tumor patients are necessary to facilitate early preventative and corrective ophthalmologic interventions.

How do different lighting conditions affect the vision and quality of life of people with glaucoma? A systematic review.

This article is a systematic review of evidence regarding the impact of different lighting conditions on the vision and quality of life (QoL) of people with primary open-angle glaucoma (POAG). A systematic literature search was carried out using CINAHL, MEDLINE, PsycARTICLES, PsycINFO, Embase, and Ovid Nursing Database for studies: published up to April 2019; including people diagnosed with POAG; and assessing visual function or QoL in response to changing lighting/luminance levels or glare. Two researchers independently screened studies for eligibility. Data were extracted from eligible studies regarding study design, participant characteristics, outcomes, and results. Quality of included studies was critically appraised. Of 8437 studies, 56 eligible studies were included. Studies investigated the effects of lighting on the following domains among people with POAG: QoL (18/56), psychophysical measures (16/56), functional vision (10/56), activities of daily living (10/56), and qualitative findings (2/56). POAG negatively affects low-luminance contrast sensitivity, glare symptoms, and dark adaptation time and extent. In vision-related QoL questionnaires, people with POAG report problems with lighting, glare, and dark adaptation more frequently than any other domain. These problems worsen with progressing visual field loss. Early-stage POAG patients experience significantly more difficulties in low-luminance or changing lighting conditions than age-matched controls (AMCs), challenging perceptions of early-stage POAG as asymptomatic. However, performance-based studies seldom show significant differences between POAG participants and AMCs on tasks simulating daily activities under non-optimal lighting conditions. Further research with larger samples is required to optimise ambient and task-oriented lighting that can support patients' adaptation to POAG.

Outcomes After Comprehensive Vision Rehabilitation Using Vision-related Quality of Life Questionnaires: Impact of Vision Impairment and National Eye Institute Visual Functioning Questionnaire.

This research is significant because, although vision-related quality of life (VRQoL) is improved after vision rehabilitation (VR), patients with certain characteristics respond less positively on VRQoL measures, and this should inform future care. The purposes of this study were to evaluate how two VRQoL questionnaires compare in measuring change in patient-reported outcomes after VR and to determine if patient characteristics or occupational therapy (OT) predict higher scores after rehabilitation. In a prospective clinical cohort study, 109 patients with low vision completed the Impact of Vision Impairment (IVI) and the National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) before and after VR. Comprehensive VR included consultation with an ophthalmologist and OT if required. The relationships of six baseline characteristics (age, sex, visual acuity, contrast sensitivity, field loss, diagnosis) and OT were assessed with VRQoL scores using multivariable logistic regression. The mean (SD) age was 68.5 (19.2) years, and 61 (56%) were female. After rehabilitation, increases in scores were observed in all IVI subscales (reading [P < .001], mobility [P = .002], well-being [P = .0003]) and all NEI VFQ-25 subscales (functional [P = .01], socioemotional [P = .003]). Those who were referred to OT but did not attend and those who had hemianopia/field loss were less likely to have higher VRQoL in IVI mobility and well-being. Those attending OT for more than 3 hours were less likely to have better scores in emotional NEI VFQ. Men were less likely to have increased scores in functional and emotional NEI VFQ, whereas those with diagnoses of nonmacular diseases had higher odds of having increased scores on the emotional NEI VFQ (all, P < .05). Both the IVI and the NEI VFQ-25 detected change in patients' VRQoL after rehabilitation. Most of the patient characteristics we considered predicted a lower likelihood of increased scores in VRQoL.

Reduced vision-related quality of life in people living with dystonia

Purpose: Dystonia is a neurological movement disorder with negative impact on function and quality of life. It is currently unclear whether vision-related quality of life is affected. The aim of this study was to determine whether vision-related quality of life is reduced by dystonia.Materials and methods: A vision-related quality of life questionnaire was delivered online to probe visual function in people living with dystonia. Scores for each of six domains were compared to normative data of 819 healthy participants using one sample t-tests. Respondents were divided into two groups based on whether they had botulinum toxin injections and compared using independent samples t-tests.Results: There were 42 completed responses. There was a difference from norm for two domains; ocular symptoms (t(41) = 2.31, p = 0.026) and role performance (t(41) = 2.85, p = 0.007). There was variation in responses for all six domains. No difference in scores for the botulinum toxin injection group was found for either domain (both p > 0.74).Conclusions: Some people with dystonia experience reduced vision-related quality of life, which has potential to contribute to their disability. Health professionals should be aware of vision-related issues when managing people with dystonia and consider appropriate rehabilitative interventions to reduce disability and enhance quality of life.Implications for rehabilitationDystonia is a neurological movement disorder resulting in abnormal postures and movements.Vision-related quality of life is reduced by dystonia which may contribute to disability and reduced function.Strategies to improve vision-related quality of life should be included in rehabilitation programmes for people living with dystonia.

Crosscultural adaptation and validation into Spanish of the questionnaire National Eye Institute Visual Function Questionnaire 25

Abstract Introduction Advances in medicine have contributed to a higher average life expectancy, as well as an increasing number of chronic diseases patients. This longevity means that the assessment of the quality of life, particularly that related to vision, has become very relevant. Objective The validation of the translation and cross-cultural adaptation into Spanish of one of the most widely used vision-related quality of life questionnaires. It has sought to ensure that the Spanish version of the questionnaire was equivalent in semantic, conceptual, and technical content and criteria level, compared to its already validated English version. Method An analytical observational study was conducted using a cohort of patients, in whom their quality of life related to vision was analyzed. The study was developed in two steps; the first was the translation and cross-cultural adaptation to Spanish of the NEI VFQ-25 questionnaire. The second one was the psychometric study of the reliability and validity of the scale of the Spanish version. Results The analysis of the terms of reliability and validity showed that the translation and cross-cultural adaptation met the expected requirements and was well accepted by users. Conclusion There is now a possibility of having a Spanish validated questionnaire available to assess the quality of life related to vision in patients with chronic diseases, such as age-related macular degeneration.

Quality of Life and Depression Level in Patients with Watery Eye.

The aim of this study was to assess subjective, human aspect of the medical condition, evaluate the quality of life (QOL) and level of depressive symptoms in patients with watery eye and compare it with patients with two most common causes of visual deterioration: cataract and macular region pathology. The results of this study may serve to raise awareness of watery eye impact on a large number of patients and subsequently promote their treatment in order to restore full visual and life quality necessary for normal human functioning. In this prospective, randomised, questionnaire-based study, we have surveyed three groups of patients with a total of 210 patients: group with the watery eye of different etiology (n=69), group with one pseudophakic eye and one cataract eye (n=73) and group with the unilateral pathology of the macular region (n=68). All three groups underwent a complete ophthalmologic examination. To examine the overall quality of life we have used a modified vision-related quality of life questionnaire (VR-QOL) and to evaluate depression level "Beck Depression Inventory - 2". The results were analyzed with statistical program STATISTICA 13. Compared to group with unilateral cataract eye and to group with unilateral pathology of the macular region, the results of this study show that patients with watery eye have significantly decreased quality of life in all daily activities, particularly in outdoor activities (F=125.80, df=2/143, p<0.01), during sports (F=36.67, df=2/143, p<0.01) and interpersonal relations (F=18.73, df=2/143, p<0.01). Results between three groups showed that group with watering eye expressed highest depression level and group with one pseudophakic eye and the other cataract eye the lowest (F=25.86, df=2/207, p<0.01). Watery eye has a significant impact on vision-related quality of life. Our research showed that patients with watery eye had expressed more depressive symptoms than other groups, but still without statistically significant value. Since it affects a large and heterogenic group of patients it is important to be recognized on time and treated etiologically in attempt to restore full function and life quality. The results of this study may serve to raise awareness of watery eye impact on a large number of patients and subsequently promote their treatment in order to restore full visual and life quality necessary for normal functioning.

Adaptación cultural y validación al castellano del cuestionario National Eye Institute Visual Function Questionnaire 25

IntroductionAdvances in medicine have contributed to a higher average life expectancy, as well as an increasing number of chronic diseases patients. This longevity means that the assessment of the quality of life, particularly that related to vision, has become very relevant. ObjectiveThe validation of the translation and cross-cultural adaptation into Spanish of one of the most widely used vision-related quality of life questionnaires. It has sought to ensure that the Spanish version of the questionnaire was equivalent in semantic, conceptual, and technical content and criteria level, compared to its already validated English version. MethodAn analytical observational study was conducted using a cohort of patients, in whom their quality of life related to vision was analysed. The study was developed in two steps; the first was the translation and cross-cultural adaptation to Spanish of the NEI VFQ-25 questionnaire. The second one was the psychometric study of the reliability and validity of the scale of the Spanish version. ResultsThe analysis of the terms of reliability and validity showed that the translation and cross-cultural adaptation met the expected requirements and was well accepted by users. ConclusionThere is now a possibility of having a Spanish validated questionnaire available to assess the quality of life related to vision in patients with chronic diseases, such as age-related macular degeneration.

A Cross-Sectional and Longitudinal Study of Retinal Sensitivity in RPE65-Associated Leber Congenital Amaurosis.

PurposeRPE65-associated Leber congenital amaurosis (RPE65-LCA) is an early-onset severe retinal dystrophy associated with progressive visual field loss. Phase I/II and III gene therapy trials have identified improved retinal sensitivity but little is known about the natural history of retinal sensitivity in RPE65-LCA.MethodsA total of 19 subjects (aged 9 to 23 years) undertook monocular full-field static perimetry of which 13 subjects were monitored longitudinally. Retinal sensitivity was measured as mean sensitivity (MS) and volumetrically quantified (in decibel-steradian) using visual field modeling and analysis software for the total (VTOT), central 30° (V30) and central 15° (V15) visual field. Correlation was evaluated between retinal sensitivity and age, best-corrected visual acuity (BCVA), contrast sensitivity, vision-related quality of life, and genotype. Test-retest reliability was also investigated.ResultsV30 was identified to have a strong, weak, and moderate correlation with age, BCVA and contrast sensitivity respectively. Furthermore, V30 was identified as having a weak linear relationship with the mobility and independence domains of the vision-related quality of life questionnaire. Longitudinal analysis demonstrated a slow loss of retinal sensitivity in this cohort. Subjects with at least one RPE65 nonsense variant appeared to show greater progressive loss of retinal sensitivity in the second decade of life than those without.ConclusionsVolumetric assessment of central 30° visual field sensitivity, V30, is a useful independent measure of retinal function and, in our data, represented the best metric to monitor deterioration of retinal sensitivity in RPE65-LCA. Furthermore, functional correlation with genotype may enable more informed prognostic counseling. (ClinicalTrials.gov number, NCT02714816.)

Nd:YAG laser vitreolysis versus pars plana vitrectomy for vitreous floaters.

The vitreous is the clear jelly of the eye and contains fine strands of proteins. Throughout life the composition of this vitreous changes, which causes the protein strands in it to bundle together and scatter light before it reaches the retina. Individuals perceive the shadows cast by these protein bundles as 'floaters'. Some people are so bothered by floaters that treatment is required to control their symptoms. Two major interventions for floaters include Nd:YAG laser vitreolysis and vitrectomy. Nd:YAG laser vitreolysis involves using laser energy to fragment the vitreous opacities via a non-invasive approach. Vitrectomy involves the surgical replacement of the patient's vitreous (including the symptomatic vitreous floaters) with an inert and translucent balanced salt solution, through small openings in the pars plana. To compare the effectiveness and safety of Nd:YAG laser vitreolysis to pars plana vitrectomy for symptomatic vitreous floaters. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 12), MEDLINE Ovid (1946 to 17 January 2017), Embase Ovid (1947 to 17 January 2017), LILACS (Latin American and Caribbean Health Sciences Literature Database) (1982 to 17 January 2017), the ISRCTN registry (www.isrctn.com/editAdvancedSearch); searched 17 January 2017, ClinicalTrials.gov (www.clinicaltrials.gov); searched 17 January 2017 and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 17 January 2017. We did not use any date or language restrictions in the electronic searches for trials. We also searched conference proceedings to identify additional studies. We included only randomised controlled trials (RCTs) that compared Nd:YAG laser vitreolysis to pars plana vitrectomy for treatment of symptomatic floaters. We planned to use methods recommended by Cochrane. The primary outcome we planned to measure was change in vision-related quality of life from baseline to 12 months, as determined by a vision-related quality of life questionnaire. The secondary outcomes we planned to measure were best corrected logMAR or Snellen visual acuity at 12 months for the treated eye(s) and costs. Adverse outcomes we planned to record were the occurrence of sight-threatening complications by 12 months (asymptomatic retinal tears, symptomatic retinal tears, retinal detachment, cataract formation, and endophthalmitis). No studies met the inclusion criteria of this review. There are currently no RCTs that compare Nd:YAG laser vitreolysis with pars plana vitrectomy for the treatment of symptomatic floaters. Properly designed RCTs are needed to evaluate the treatment outcomes from the interventions described. We recommend future studies randomise participants to either a Nd:YAG laser vitreolysis group or a vitrectomy group, with participants in each group assigned to either receive treatment or a sham intervention. Future studies should follow participants at six months and 12 months after the intervention. Also they should use best corrected visual acuity (BCVA) using an Early Treatment of Diabetic Retinopathy Study (ETDRS) chart read at 4 metres, vision-related quality of life (VRQOL), and adverse outcomes as the outcome measures of the trial.

Development and validation of a vision and night driving questionnaire.

Night-time driving difficulties are a common concern of older drivers and those with eye disease. This study aimed to develop and validate a questionnaire for assessing vision-related night driving difficulties in older drivers. Items from existing vision-related quality of life questionnaires and driving studies were used to develop a questionnaire that was completed by 283 participants who reported visual difficulties for night driving (65% female, 50 to >80years). The questionnaire included items relating to demographic and night driving characteristics (seven items), general vision ratings (eight items), vision-related night driving difficulties (11 items), and a single open question about specific night driving difficulties. The vision-related night driving difficulty items were analysed separately using Rasch analysis to form the vision and night driving questionnaire (VND-Q). Rasch analysis assessed validity and psychometric properties of the scale. Generalised linear regression models examined associations between VND-Q scores and age, gender, amount of night driving, self-rated vision, and eye conditions. Test-retest repeatability was assessed using intra-class correlation analysis and Bland-Altman methods of agreement for a subset of 30 participants. Rasch analysis indicated that a nine-item VND-Q scale was unidimensional, valid and reliable, and showed excellent discriminant ability (person separation index 3.04; person reliability 0.90). Targeting was better for those with greater self-reported night driving difficulties. Participants with self-reported bilateral eye conditions and worse self-reported general vision ratings had significantly more night driving difficulties with the VND-Q scale than individuals without eye conditions (p=0.03) and with better general vision ratings (p<0.001). Females reported more difficulties than males (p<0.001) and drove shorter distances at night per week which was also associated with greater difficulties (p<0.001). A repeatability coefficient (Rc ) of 2.07 demonstrated excellent test-retest repeatability. The nine-item VND-Q is a unidimensional and reliable questionnaire allowing quantification of the level of visual difficulties that older drivers report at night. The development of this questionnaire is an important step in providing a reliable and validated instrument for use to guide appropriate investigations, referrals, or interventions in clinical and research settings.

Systematic review of vision-related quality of life questionnaires for older institutionalised seniors with dementia.

In view of our interest in helping older institutionalised adults with co-existing visual and cognitive deficits, our objective was to review vision-related quality of life (VRQoL) questionnaires developed for people with dementia. A systematic literature search was performed in seven relevant databases, limited to peer-reviewed journals published in English, French, Spanish, Italian or German languages, between 1982 and 2012. The retained VRQoL questionnaires were described. Only relevant articles that fully meet our target population and interest criteria were eligible for psychometric properties rating. The literature search identified 461 potentially relevant articles, from which 69 were isolated and reviewed. Eight articles presented questionnaires that were administered to older institutionalised individuals with dementia. Three VRQoL questionnaires were identified, from which only one was designed and validated for those with mild to moderate dementia and none for individuals with more advanced dementia. There is a pressing need to build and validate a questionnaire for assessing VRQoL in older institutionalised individuals with dementia, to provide a research tool capable of evaluating how changes in vision impact their QoL.