Visual Disability Research Articles

On the issue of the new edition of the international classification of retinopathy of prematurity. Part 2

Retinopathy of prematurity (ROP) is the leading cause of visual disability from early childhood. Foreign researchers and clinicians are focused on studying a new pharmacological method of treatment of active RN using anti-VEGF drugs, which was a reason that prompted updates in the International Classification of Retinopathy of Prematurity (ICROP) in 2021. The second part of the article presents new terms recommended by the Committee for the ICROP: “regression,” which refers to the involution and resolution of the disease, and “reactivation,” which denotes a recurrence of signs in the acute phase. Notably, the latest edition of the ICROP requires a deep understanding and accurate application by domestic specialists treating ROP. This contributes to the standardization of therapeutic and diagnostic processes, therefore, improving the quality of ROP treatment in Russia.

Reactivation of retinopathy of prematurity after ranibizumab treatment

Retinopathy of prematurity (ROP) is one of the most common causes of visual disability in children born prematurely. Intravitreal injection of angiogenesis inhibitors (antivascular endothelial growth factor [VEGF] therapy) is considered one of the conservative methods of treating ROP. Aim: This study aimed to present a clinical case of ROP reactivation after intravitreal injection of the antiVEGF drug ranibizumab (Lucentis). MATERIAL AND METHODS: The course of retinopathy in a premature infant with extremely low birth weight was studied. RESULTS: A patient diagnosed with ROP, a posterior aggressive form of both eyes, received intravitreal injections of an angiogenesis inhibitor at 36 postconceptional weeks. During subsequent follow-up, disease progression was noted, which necessitated repeated ranibizumab administrations to both eyes. Over time, tractional retinal detachment developed in the right eye, and the disease progressed more slowly in the left eye. At the age of 1 year, ROP rapidly progressed to stage 4B in the left eye. Lens vitrectomy was performed sequentially on the right and then on the left eye. At the age of 1.5 years, the patient had coarse preretinal adhesions in the posterior pole of both eyes and had no spatial vision, whereas light perception was preserved. CONCLUSION: Intravitreal ranibizumab administration for posteriorly aggressive ROP does not exclude its reactivation both early and late after administrations. Further improvement in treatment methods for ROP is necessary.

Association Between Age-Related Macular Degeneration With Visual Disability and Risk of Dementia: A Nationwide Cohort Study

ObjectivesTo investigate the prospective association between the risk of dementia and age-related macular degeneration (AMD) in patients with related visual disability (VD). DesignA nationwide population-based cohort study used authorized data provided by the Korean National Health Insurance Service. Setting and ParticipantsA total of 1,788,457 individuals aged >50 years who participated in the Korean National Health Screening Program were enrolled. MethodsFrom January 2009 to December 2019, participants were tracked for a diagnosis of dementia using registered diagnostic codes from claims data. Participants with VD were defined as those registered in a national disability registration established by the Korean government. The prospective association of AMD and related VD with new-onset dementia was investigated using a multivariate-adjusted Cox proportional hazard model adjusted for age, sex, body mass index, income level, systemic comorbidities, psychiatric diseases, and behavioral factors. ResultsDuring the average follow-up period of 9.7 ± 2.16 years, 4260 of 21,384 participants in the AMD cohort and 137,166 of 1,662,319 participants in the control cohort were newly diagnosed with dementia, respectively. Participants diagnosed with AMD showed a higher risk of new-onset dementia than those in the control group in the fully adjusted model [hazard ratio (HR) 1.11, 95% CI 1.07–1.14]. The risk of dementia was higher in participants diagnosed with AMD and associated VD (HR 1.28, 95% CI 1.15–1.43) compared to those without VD (HR 1.09, 95% CI 1.06–1.13). Conclusions and ImplicationsA diagnosis of AMD was associated with an increased risk of all-cause dementia and its major subtypes. Close monitoring of cognitive function in AMD patients, especially those with VD, may help in early detection of all-cause dementia, which could reduce the socioeconomic burden and improve the quality of life of patients.

Natural Disaster Vulnerability Among People with Disabilities: Insights from the 2024 Household Pulse Survey

BackgroundNatural disasters pose global challenges, with their frequency and severity increasing annually, impacting communities worldwide. People with disabilities are disproportionately vulnerable to experiencing adverse mental health outcomes in the aftermath of such events, yet this critical issue remains inadequately studied. ObjectiveThis paper examines the impact of natural disasters on people with disabilities, focusing on their displacement patterns and mental well-being, to enhance our understanding of health vulnerabilities and the specific needs in emergency response. MethodsData from the nationally representative 2024 Household Pulse Survey were analyzed to assess the duration of displacement and the severity of mental distress among individuals with and without disabilities following natural disasters. Generalized Estimating Equations were employed to predict post-disaster outcomes, adjusting for demographic characteristics, socioeconomic factors, and household structure. ResultsIndividuals with vision disabilities (CI: 0.024–0.137) and those with multiple disabilities (CI: 0.020–0.068) experienced significantly longer periods of displacement compared to non-disabled people. Additionally, people with cognitive disabilities reported significantly higher levels of mental distress than their non-disabled counterparts (CI: 0.149–0.236). ConclusionFindings from this study demonstrate the need for specialized disaster response protocols that prioritize accessibility, mental health support, and targeted assistance for different disability types. Future emergency preparedness policies should incorporate disability-specific considerations, including enhanced evacuation planning, accessible mental health services, and strengthened community support systems. Disaster response frameworks must evolve to address these documented vulnerabilities, ensuring equitable support for all community members during and after natural disasters.

ANÁLISE DA COMPOSIÇÃO CORPORAL E APTIDÃO FÍSICA DE ATLETAS PARALÍMPICOS DE RIO BRANCO ACRE

Introduction: Sports training techniques have sparked interest in detailing the physical and physiological characteristics of athletes to prescribe training specifically tailored to their goals. Objective: This study aimed to analyze body composition and its relationship with physical fitness in Paralympic athletes from Rio Branco, Acre. Method: The sample consisted of 33 athletes from the Paralympic Reference Center of Rio Branco, aged between 11 and 54 years, including 20 with intellectual disabilities, 11 with physical disabilities, and 2 with visual disabilities. Measurements included body mass, height, circumferences, and skinfold thickness. Physical performance was evaluated through handgrip strength (using a hydraulic hand dynamometer in kilograms), speed (30-meter test), upper limb power (medicine ball throw test), and maximum oxygen consumption (beep test). Results: Statistical analysis included Pearson’s correlation coefficient and the Kruskal-Wallis test, with significance set at p<0.05, using SPSS software (version 29.0). Body mass index (BMI) and body mass were significantly different between athletes with physical and intellectual disabilities. A negative correlation was observed between aerobic performance (VO2max) and variables such as age (r= -0.441, p= 0.010), BMI (r= -0.590, p<0.001), body mass (r= -0.376, p= 0.031), and body fat index (BFI) (r= -0.688, p<0.001). Additionally, BFI showed a positive correlation with speed performance (r= 0.603, p= 0.001). Conclusion: Body composition significantly influences physical performance variables, indicating that factors such as BMI, body mass, and BFI impact the sports performance of Paralympic athletes.

An assessment of Discectomy Surgery on Prolapsed Lumbar Intervertebral Disc

Background: Basically, human backbone or spinal column is of a chain of bones also known as vertebrae. Spinal cord runs through the spinal column. Lumbar discectomy is a type of surgery to fix a disc in the lower back portion of human body. This surgery uses smaller cuts (incisions) than an open lumbar discectomy. We have very few proved data regarding the effectiveness of discectomy surgery on prolapsed lumbar intervertebral disc.Aim of the study: The aim of this study was to assess the role of discectomy surgery on prolapsed lumbar intervertebral disc.Methods: This was a prospective observational study which was conducted at the Department of Orthopedics Surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from January 2017 to December 2017. In total 38 patients with low back pain selected for discectomy surgery on prolapsed lumbar intervertebral disc were enrolled as the study population. This study was approved by the ethical committee of the mentioned hospital. Proper written consents were taken from all the participants before starting data collection. A pre-designed questionnaire was used in patent data collection. Radicular pain was observed by visual analogue score and disability status was done by using Oswestry disability index. By using modified Macnab criteria, outcome of the surgery was determined. All data were processed, analyzed and disseminated by MS Office and SPSS version as per need.Result: In our study as postoperative complication dural tear, superficial wound infection and foot drop were observed in 57.14% (Highest), 28.57% and 14.29% (Lowest) participants respectively. In analyzing radicular pain among the participants, we observed that VAS score had been reduced to 1.6±1.2 from 7.2±5.4 within one year of surgery which was 2.7±1.3 at immediate postoperative period. On the other hand, in analyzing Disability status among the participants we observed that, ODI index had been reduced to 10±1 from 64±8 within one year of surgery which was 17±6 at immediate postoperative period. According to the Modified Macnab Criteria in analyzing the final outcome among the participants we observed 52.63%, 39.47%, 5.26% and 2.63% participants got ‘Excellent’ (Highest), ‘Good’, ‘Fair’ and ‘Poor’ (Lowest) results respectively.Conclusion: In terms of reduction of pain, complication and disability scores it was noted that, in the surgery of prolapsed lumbar intervertebral disc the surgical outcome after one year period of discectomy is quite satisfactory. Considering the cost effectiveness and short treatment duration this surgical method may consider as the choice of method for treating patients with prolapsed lumbar intervertebral disc.

Diabetes mellitus as a risk factor for development retinopathy of prematurity. Review

Retinopathy of prematurity (ROP) is a complex and unresolved problem in pediatric ophthalmology, leading to visual disability. Low birth weight and prematurity are the main risk factors, and they form the basis of clinical recommendations for screening for ROP in all children under 35 weeks of gestational age and weighing less than 2000 g. However, many researchers point to other risk factors that can be divided into maternal, prenatal and perinatal. In this review, we consider maternal diabetes mellitus as a risk factor for ROP. Changes in the retina in premature infants and mothers with diabetes mellitus have some common features, since pathological angiogenesis occurs at the basis of these diseases. In addition, diabetes is a risk factor for preterm birth, and prematurity is a leading cause of neonatal morbidity, including the development of ROP. This suggests that maternal diabetes mellitus may have both direct and indirect effects on the development of ROP. To develop predictive models, an understanding of risk factors for ROP, the pathophysiology of retinal vascular diseases, and diseases of prematurity is necessary.

Towards Recommendations for the Universal Design of Online Authentication Systems.

There is a growing body of research on the problems older and disabled people face with authentication systems and a range of solutions have been developed. However, this research has not been integrated across user groups and solutions usually only target one or two groups. This research has attempted to integrate the empirical research findings across studies conducted with people with visual, physical, and intellectual disabilities, people dyslexia and older people. It proposes an initial set of 15 recommendations for the universal design of authentication systems. Four recommendations are about authentication systems in general, six about password authentication, two about CAPTCHAs and three about biometric authentication. 40% of the recommendations address problems experienced by at least two different user groups and over 25% address problems experienced by three groups. However, much further work is needed to validate and refine the recommendations and integrate them into a universal design approach.

Effect of yoga-based exercise program in female patients with myofacial pain of temporomandibular disorders.

The study was conducted to investigate the effect of Yoga-based exercise program on pain, range of motion (ROM), quality of sleep, depression and quality of life in female patients with myofacial pain of temporomandibular disorders (TMD). 39 Female patients with myofacial pain of TMD were included in the study. Yoga based exercise program was performed to the first group and second group was control group. Visual Analog Scale (VAS), Neck Pain and Disability Scale (NPDS), neck and jaw ROM, Pittsburg Sleep Quality Index (PUQI), Beck Depression Inventory (BDI) and Short Form 36 (SF36) were evaluated. Evaluations were repeated before treatment and 6 weeks later. From the measurements, a decrease in Temporomandibular Joint (TMJ) (p = 0.005) and neck pain (p = 0.031) was found to be significant in favor of Yoga Group. It was also observed that the increase in ROM in the neck right lateral flexion (p = 0.001) in favor of Yoga Group. The sleep quality did not change. In yoga group, a decrease in depression level (p = 0,023) and increase Quality of life in parameters of physical function (p = 0.023), vital capacity (p = 0.026), emotional health (p = 0.002), mental health (p = 0.080) were found as significant, statistically. It was concluded that yoga-based exercise program can be used as an alternative program in patients with myofacial pain of TMD. Further study on myofascial pain of TMD is recommended. Yoga-based exercise program can be used in patients with myofascial pain due to TMD.

Toward a better understanding of barriers to wayfinding technology use for people with disabilities

ABSTRACT Wayfinding is the process of navigating from one’s present location to their desired location. While wayfinding technologies are increasingly used by people with disabilities, there is little understanding of the barriers specific to wayfinding technology. The objective of this study was to understand the wayfinding technology barriers experienced by Canadians with disabilities. A total of 213 participants with varying disabilities (i.e. mobility, visual, hearing, memory and learning disabilities) completed a survey of open-ended questions about their personal experiences with different types of technologies. Technologies were categorized into public (i.e. digital and tactile interfaces) and personalized (i.e. mobile/website applications, wearable devices, smart assistive devices), and qualitative content analysis was used. Main themes were identified and either common across both groups (i.e. compatibility, demands on personal resources, information provision, interactability) or specific to one technology type (i.e. stigma, specific to personalized technology). Detailed subthemes provided greater specificity on the types of barriers encountered. For example, infection risk was noted as a barrier to public technology and high costs was a barrier for personalized technology. Results support the inclusion of wayfinding technology within accessibility standards and provide insights to clinicians on how to best support people with disabilities and their use of technology.

A Qualitative Evaluation of the Usability and Accessibility of Home COVID-19 Tests Among People with Disabilities

Home COVID-19 test kits are increasingly available in the United States, and efforts are underway to develop ones that are more accessible to people with disabilities. The primary objective of this research was to assess the usability and accessibility of existing home COVID-19 tests among people with disabilities. The aim is to better understand their needs and provide evidence for improved product design. A survey that included short-response questions about user experience with various home COVID-19 test kits was completed by 219 people with vision and mobility-related disabilities. A thematic analysis identified three overarching themes: Ease of Use, Privacy and Autonomy in Home COVID-19 Testing, and Recommendations for Improvement. The results of this study contribute to an increased understanding of how to design appropriate, accessible home COVID-19 test kits for people with disabilities.

Gaps in PM&R for Blindness & Low Vision: The Imperative of Rehabilitation for Visual Disability

Abstract Persons with blindness and low vision (pBLV) experience increased fall and injury risk beyond atypical biomechanics and balance impairments. Falling risk doubles with blindness, and more than triples with depth perception losses. Despite this, physical therapy (PT) focuses on musculoskeletal injuries post-event rather than taking a proactive and preventative approach for pBLV. We posit that PT implemented pre-injury, alongside orientation and mobility (O&M) training of adapted movement protocols could positively affect injury avoidance and severity for pBLV. The global VISION 2020 initiative seeks increased access to rehabilitation services and treatments to enhance quality-of-life for pBLV. In support, this paper reviews research studies in rehabilitation science that promote physical health and wellbeing, and stresses preventative skilled mobility and therapeutic exercise to mitigate injury. To reduce the personal, financial, and societal costs associated with BLV, as well as position patients for better outcomes, we review an evidence base that may generate immediate impact in this area. While these recommendations provide an initial framework, the role of PT in pre-habilitative care remains a critical gap that must be addressed. It is imperative that interventions, guidelines, impairment/severity-specific practices, and overall health promotion are re-evaluated and redesigned for pBLV, affording equity for health and mobility.

Making Quick-Build Sidewalk Extensions Accessible to Pedestrians with Vision Disabilities

Quick-build sidewalk extensions that shorten crossing distances and improve visibility between drivers and pedestrians waiting to cross the street are understood by most travelers, but wayfinding is difficult for pedestrians with vision disabilities who are unlikely to know they exist without specific familiarization. This research evaluated the effectiveness of three potential treatments for mitigating these wayfinding problems, all of which resulted in improvements in measures of wayfinding: 1) removing the detectable warning surface (DWS) from the curb ramp and installing DWS across the width of the crosswalk at the perimeter of the sidewalk extension; 2) placing a 24-inch wide strip of raised-bar tactile direction indicators with bars oriented perpendicular to the crossing direction along one side of the curb ramp and extending through the sidewalk extension to the DWS at the perimeter; and 3) placing trapezoidal tactile warning delineators (TWDs) along the edges of the crosswalk, within the sidewalk extension, to delineate the pedestrian path. A combination of moving the DWS and installing TWDs along crosswalk edges resulted in the most accurate and effective wayfinding to and through the quick-build sidewalk extension. The spacing of vertical perimeter elements (e.g., flexible posts) to ensure they were detectable by pedestrians with vision disabilities was also evaluated. Participants who traveled outside the crosswalk reliably encountered and detected at least one vertical perimeter element when the maximum separation between vertical elements was 24 inches. The perimeter was not reliably encountered and detected when the separation between vertical elements was considerably greater.

InclusiveWeb : A Smart Browser Approach to Enhancing Web Accessibility for Users with Diverse Disabilities

This article presents InclusiveWeb, an innovative accessibility-focused web browser designed to enhance digital inclusion for users with diverse disabilities. The browser addresses the persistent challenge of widespread non-compliance with web accessibility standards by implementing real-time content adaptation mechanisms, disability-specific tools, and a highly customizable user interface. InclusiveWeb's architecture incorporates advanced machine learning algorithms to dynamically modify web content, offering tailored solutions for users with visual impairments, dyslexia, language disorders, cognitive disabilities, and ADHD. The article details the browser's design principles, technical considerations, and user experience features, supported by a comprehensive evaluation methodology involving user studies with various disability groups. Results demonstrate significant improvements in task completion rates, user satisfaction, and overall accessibility compared to standard browsers. While acknowledging limitations and areas for future research, this article highlights InclusiveWeb's potential to revolutionize web accessibility, shifting the paradigm from reliance on content creators' compliance to browser-level adaptations. The implications of this approach for web accessibility standards, digital inclusion, and future technological developments are discussed, emphasizing the browser's role in creating a more equitable digital landscape.

Coinciding Diabetic Retinopathy and Diabetic Macular Edema Grading With Rat Swarm Optimization Algorithm for Enhanced Capsule Generation Adversarial Network.

In the worldwide working-age population, visual disability and blindness are common conditions caused by diabetic retinopathy (DR) and diabetic macular edema (DME). Nowadays, due to diabetes, many people are affected by eye-related issues. Among these, DR and DME are the two foremost eye diseases, the severity of which may lead to some eye-related problems and blindness. Early detection of DR and DME is essential to preventing vision loss. Therefore, an enhanced capsule generation adversarial network (ECGAN) optimized with the rat swarm optimization (RSO) approach is proposed in this article to coincide with DR and DME grading (DR-DME-ECGAN-RSO-ISBI 2018 IDRiD). The input images are obtained from the ISBI 2018 unbalanced DR grading data set. Then, the input fundus images are preprocessed using the Savitzky-Golay (SG) filter filtering technique, which reduces noise from the input image. The preprocessed image is fed to the discrete shearlet transform (DST) for feature extraction. The extracting features of DR-DME are given to the ECGAN-RSO algorithm to categorize the grading of DR and DME disorders. The proposed approach is implemented in Python and achieves better accuracy by 7.94%, 36.66%, and 4.88% compared to the existing models, such as the combined DR with DME grading for the cross-disease attention network (DR-DME-CANet-ISBI 2018 IDRiD), category attention block for unbalanced grading of DR (DR-DME-HDLCNN-MGMO-ISBI 2018 IDRiD), combined DR-DME classification with a deep learning-convolutional neural network-based modified gray-wolf optimizer with variable weights (DR-DME-ANN-ISBI 2018 IDRiD).

Guidance device for visually impaired people based on ultrasonic signals and open hardware

<span>Visual impairment is a complex challenge that affects people of all ages, and it is estimated that around 2.2 billion people worldwide lack adequate access to medical treatment and support. In Latin America, there is a lack of attention to people with visual disabilities, evidenced by poor urban infrastructure and lack of compliance with inclusion laws. Some projects stand out for the use of prototypes with artificial vision technology, global positioning system (GPS) and smart canes. Therefore, the objective of the project is to use ultrasonic sensors and a low-cost electronic device coupled to canes, for obstacle detection and mobility using an open hardware embedded system. The results confirmed the efficiency in the detection and operation of the ultrasonic sensor by activating the light emitting diode (LED), the buzzer and the vibrating motor according to the programmed distances. Challenges were identified, such as adapting the sensor to the tilt of the cane and the importance of accurate calibration of the ultrasonic sensor. The system met its objectives by detecting objects in a range of 2 to 50 cm and providing sound alerts to improve the perception of blind people.</span>

Retinal Damage and Visual Network Reconfiguration Defines Visual Function Recovery in Optic Neuritis.

Recovery of vision after acute optic neuritis (AON) is critical to improving the quality of life of people with demyelinating diseases. The objective of the study was to prospectively assess the changes in visual acuity, retinal layer thickness, and cortical visual network in patients with AON to identify the predictors of permanent visual disability. We studied a prospective cohort of 88 consecutive patients with AON with 6-month follow-up using high and low-contrast (2.5%) visual acuity, color vision, retinal thickness from optical coherence tomography, latencies and amplitudes of multifocal visual evoked potentials, mean deviation of visual fields, and diffusion-based structural (n = 53) and functional (n = 19) brain MRI to analyze the cortical visual network. The primary outcome was 2.5% low-contrast vision, and data were analyzed with mixed-effects and multivariate regression models. We found that after 6 months, low-contrast vision and quality of vision remained moderately impaired. The thickness of the ganglion cell layer at baseline was a predictor of low-contrast vision 6 months later (ß = 0.49 [CI 0.11-0.88], p = 0.012). The structural cortical visual network at baseline predicted low-contrast vision, the best predictors being the betweenness of the right parahippocampal cortex (ß = -036 [CI -0.66 to 0.06], p = 0.021), the node strength of the right V3 (ß = 1.72 [CI 0.29-3.15], p = 0.02), and the clustering coefficient of the left intraparietal sulcus (ß = 57.8 [CI 12.3-103.4], p = 0.015). The functional cortical visual network at baseline also predicted low-contrast vision, the best predictors being the betweenness of the left ventral occipital cortex (ß = 8.6 [CI: 4.03-13.3], p = 0.009), the node strength of the right intraparietal sulcus (ß = -2.79 [CI: -5.1-0.4], p = 0.03), and the clustering coefficient of the left superior parietal lobule (ß = 501.5 [CI 50.8-952.2], p = 0.03). The assessment of the visual pathway at baseline predicts permanent vision disability after AON, indicating that damage is produced early after disease onset and that it can be used for defining vision impairment and guiding therapy.

Universal Design for Learning as a pathway to accessibility in the linguistics classroom

This paper offers suggestions on enhancing accessibility in our introductory linguistics courses, with a particular focus on teaching phonetics and phonology to students with hearing and visual disabilities. After reviewing some existing resources designed to make linguistics content more accessible, we address some of the practical constraints we experienced in trying to adopt these resources for our own courses. In light of such challenges, we offer practical strategies for improving accessibility both in the physical classroom as well as for online or hybrid courses. We suggest that implementing such strategies, which are in line with the principles of Universal Design for Learning, can prove beneficial for all students, with or without the need for accommodation. Finally, we encourage instructors to take proactive steps to make their course content more accessible, both in their current and future classes.

Is the delivery of National Disability Insurance Scheme in Australia through quasi markets achieving the right outcomes in vision rehabilitation services? A qualitative study

Purpose Despite being a pioneering social initiative worldwide, Australia’s National Disability Insurance Scheme (NDIS) still presents unresolved issues for individuals with vision-related disability regarding its processes and outcomes. This study evaluates how well the NDIS markets are perceived to achieve efficiency, responsiveness, choice, quality, and equity within the vision rehabilitation sector, and identified factors facilitating or hindering desired outcomes. Materials and methods This qualitative study conducted 22 semi-structured interviews involving individuals with vision disability, service providers, peak-body and professional-body representatives, and an NDIS planner. Results Findings across stakeholder groups show minimal variation. The NDIS’s quasi-market approach has improved participants’ choices over ways to utilise and manage their funding and consequently provided them with a sense of control and empowerment. However, inefficiencies persist due to insufficient competition, workforce shortages, price caps, information asymmetry, high transaction costs, gaming behaviour, inadequate staff training, complex and lengthy processes, and eligibility concerns. Supportive factors include effective advocacy, pragmatic regulations to maintain quality, opportunities for innovation, and service providers’ motivation for cost-effectiveness. Conclusions While NDIS markets have made significant strides in enhancing participants’ choice and control, our findings underscore the need for continued refinement to achieve broader social objectives and long-term sustainability for individuals with vision-related disability.

Assessment of disability and disease burden in neuromyelitis optica spectrum disorders in the CIRCLES Cohort

Neuromyelitis optica spectrum disorders (NMOSD) comprise autoimmune diseases imposing substantial disability. We compared an NMOSD-targeted disability assessment of mobility, vision, and self-care domains (individually and composite) with the multiple sclerosis-targeted Expanded Disability Status Scale (EDSS) to assess NMOSD disease burden. An overall cohort (n = 505) and a subset of these patients with an enriched dataset (n = 198) were analyzed from the CIRCLES longitudinal, observational database of patients with AQP4-IgG–seropositive or –seronegative NMOSD in North America. Multinomial modeling was used to identify temporal correlates of disability improvement, stability, and worsening. Prior on-study relapse correlated with worsening mobility (OR, 3.08; 95% CI: 1.61–5.90), vision (OR, 3.99; 95% CI: 2.03–7.86), self-care disability (OR, 1.90; 95% CI: 1.07–3.38), and mean composite index disability (OR, 4.20; 95% CI: 1.71–10.34). Higher vision disability was associated with Black race, shorter time on-study, and AQP4-IgG–seropositive status in patients ≥ 18 years (p < 0.05). Disease onset phenotype and sex correlated with pain interference (p < 0.05). These correlates of NMOSD disability were undetected by EDSS. The CIRCLES real-world experience supports the need for NMOSD-specific disability assessment to improve recognition of disease burden, facilitate proactive clinical management, offer insights into resilience, and inform clinical trial design.