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Comparing the Impact of Refractive and Nonrefractive Vision Loss on Functioning and Disability

Comparing the Impact of Refractive and Nonrefractive Vision Loss on Functioning and Disability

Authors :
Pradeep Y. Ramulu
Robert W. Massof
Beatriz Munoz
Suzanne W. van Landingham
Nazlee Zebardast
Bonnielin K. Swenor
Sheila K. West
Source :
Ophthalmology. 122:1102-1110
Publication Year :
2015
Publisher :
Elsevier BV, 2015.

Abstract

Purpose To compare the effects of uncorrected refractive error (URE) and nonrefractive visual impairment (VI) on performance and disability measures. Design Cross-sectional, population-based study. Participants A total of 2469 individuals with binocular presenting visual acuity (PVA) of ≥20/80 who participated in the first round of the Salisbury Eye Evaluation study. Methods The URE was defined as binocular PVA of ≤20/30, improving to >20/30 with subjective refraction. The VI was defined as post-refraction binocular best-corrected visual acuity (BCVA) of ≤20/30. The visual acuity decrement due to VI was calculated as the difference between BCVA and 20/30, whereas visual acuity due to URE was taken as the difference between PVA and BCVA. Multivariable regression analyses were used to assess the disability impact of (1) vision status (VI, URE, or normal vision) using the group with normal vision as reference and (2) a 1-line decrement in acuity due to VI or URE. Main Outcome Measures Objective measures of visual function were obtained from timed performance of mobility and near vision tasks, self-reported driving cessation, and self-reported visual difficulty measured by the Activities of Daily Vision (ADV) scale. The ADV responses were analyzed using Rasch analysis to determine visual ability. Results Compared with individuals with normal vision, subjects with VI (n = 191) had significantly poorer objective and subjective visual functioning in all metrics examined ( P P Conclusions Visual impairment is associated with greater disability than URE across a wide variety of functional measures, even in analyses adjusting for the severity of vision loss. Refractive and nonrefractive vision loss should be distinguished in studies evaluating visual disability and be understood to have differing consequences.

Details

ISSN :
01616420
Volume :
122
Database :
OpenAIRE
Journal :
Ophthalmology
Accession number :
edsair.doi...........b4c70406bb7de9f441d83a129234b9f8
Full Text :
https://doi.org/10.1016/j.ophtha.2015.02.024