Impact of unilateral and bilateral vision loss on quality of life

Centre for Eye Research Australia, University of Melbourne, East Melbourne, Vicoria 3002, Australia.
British Journal of Ophthalmology (Impact Factor: 2.98). 04/2005; 89(3):360-3. DOI: 10.1136/bjo.2004.047498
Source: PubMed


To investigate whether unilateral vision loss reduced any aspects of quality of life in comparison with normal vision and to compare its impact with that of bilateral vision loss.
This study used cluster stratified random sample of 3271 urban participants recruited between 1992 and 1994 for the Melbourne Visual Impairment Project. All predictors and outcomes were from the 5 year follow up examinations conducted in 1997-9.
There were 2530 participants who attended the follow up survey and had measurement of presenting visual acuity. Both unilateral and bilateral vision loss were significantly associated with increased odds of having problems in visual functions including reading the telephone book, newspaper, watching television, and seeing faces. Non-correctable by refraction unilateral vision loss increased the odds of falling when away from home (OR = 2.86, 95% CI 1.16 to 7.08), getting help with chores (OR = 3.09, 95% CI 1.40 to 6.83), and becoming dependent (getting help with meals and chores) (OR = 7.50, 95% CI 1.97 to 28.6). Non-correctable bilateral visual loss was associated with many activities of daily living except falling.
Non-correctable unilateral vision loss was associated with issues of safety and independent living while non-correctable bilateral vision loss was associated with nursing home placement, emotional wellbeing, use of community services, and activities of daily living. Correctable or treatable vision loss should be detected and attended to.

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Available from: Jill E Keeffe, Mar 16, 2014
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    • "In turn, high myopia is associated with a high risk of blinding complications such as myopic fundus disease, cataract, and glaucoma [6] [7]. All the abovementioned ailments require significant health care expenditure and are related to declined vision-related quality of life [8]. Myopic progression in young children is primarily due to eye elongation; in other words, the elongation of the axial length (AL) must be slowed to control myopia [9] [10]. "
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    ABSTRACT: Background. To evaluate the efficacy and acceptability of orthokeratology for slowing myopic progression in children with a well conducted evidence-based analysis. Design. Meta-analysis. Participants. Children from previously reported comparative studies were treated by orthokeratology versus control. Methods. A systematic literature retrieval was conducted in MEDLINE, EMBASE, Cochrane Library, World Health Organization International Clinical Trials Registry Platform, and The included studies were subjected to meta-analysis using Stata version 10.1. Main Outcome Measures. Axial length change (efficacy) and dropout rates (acceptability) during 2-year follow-up. Results. Eight studies involving 769 subjects were included. At 2-year follow-up, a statistically significant difference was observed in axial length change between the orthokeratology and control groups, with a weighted mean difference (WMD) of −0.25 mm (95% CI, −0.30 to −0.21). The pooled myopic control rate declined with time, with 55, 51, 51, and 41% obtained after 6, 12, 18, and 24 months of treatment, respectively. No statistically significant difference was obtained for dropout rates between the orthokeratology and control groups at 2-year follow-up (OR, 0.79; 95% CI, 0.52 to 1.22). Conclusions. Orthokeratology is effective and acceptable for slowing myopic progression in children with careful education and monitoring.
    Journal of Ophthalmology 07/2015; 2015:1-12. DOI:10.1155/2015/360806 · 1.43 Impact Factor
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    • "The decline of VRQoL with worsening vision impairment has been shown for Western countries49–52 and Asia. This decline was generally described to be independent of specific ocular conditions such as glaucoma or diabetic retinopathy, suggesting that VRQoL is affected across ocular conditions once eyes reach the severe stage of disease, where distance VA and VF may be considerably affected. "
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    ABSTRACT: Purpose Patients with eye diseases often have a better-seeing eye (BSE) and a worse-seeing eye (WSE). This review will carve out the current knowledge in which the relationship to BSEs and WSEs contributes to overall visual functioning and vision-related quality of life (VRQoL). Methods Searches were from database inception to the current date. Terms used for the search were “better eye”, “worse eye”, “utility”, “life quality”, “quality of life”, “VFQ-25”, and “visual acuity”. Results There is a lack of a clear definition for BSE and WSE, and the used definitions are regularly dependent on the underlying eye disease. “BSE” and “WSE” can interact in terms of binocular inhibition or summation. Measured influences of the BSE and WSE on VRQoL are dependent on the underlying instrument used for the measurement. Several studies show impaired VRQoL if only one eye is affected from disease, with unimpaired vision of the BSE. VRQoL can improve significantly when treating the BSE and the WSE. In eye diseases with impairment of the central vision, there is a better correlation between the BSE and VRQoL. However, in eye diseases with peripheral vision impairment, eg, glaucoma, functional parameters of the WSE are better predictors for VRQoL. Conclusion The WSE appears to have a stronger influence on VRQoL than is generally assumed. This is especially the case if the underlying eye disease does not affect central vision but peripheral vision.
    Clinical ophthalmology (Auckland, N.Z.) 09/2014; 8:1703-9. DOI:10.2147/OPTH.S64200
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    • "However, this disregards the considerable loss of visual field, depth perception, as well as the anxiety caused by only having one seeing eye. Even unilateral vision loss has been shown to reduce independence considerably.[5] Similarly, use of the better eye only disregards the considerable impact of vision-restoring treatment in the worse eye, as achieved by for example cataract surgery or anti-VEGF treatment for neovascular age-related macular degeneration.[6] "
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    ABSTRACT: To assess the impact of VA loss on patient reported utilities taking both eyes into account compared to taking only the better or the worse eye into account. In this cross-sectional study 1085 patients and 254 controls rated preferences with the generic health-related (EQ-5D; n = 868) and vision-specific (Vision and Quality of Life Index (VisQoL); n = 837) multi-attribute utility instruments (MAUIs). Utilities were calculated for three levels of VA in the better and worse eyes, as well as for 6 different vision states based on combinations of the better and worse eye VA. Using the VisQoL, utility scores decreased significantly with deteriorating vision in both the better and worse eyes when analysed separately. When stratified by the 6 vision states, VisQoL utilities decreased as VA declined in the worse eye despite stable VA in the better eye. Differences in VisQoL scores were statistically significant for cases where the better eye had no vision impairment and the worse seeing fellow eye had mild, moderate or severe vision impairment. In contrast, the EQ-5D failed to capture changes in better or worse eye VA, or any of the six vision states. Calculating utilities based only on better eye VA or using a generic MAUI is likely to underestimate the impact of vision impairment, particularly when the better eye has no or little VA loss and the worse eye is moderately to severely visually impaired. These findings have considerable implications for the assessment of overall visual impairment as well as economic evaluations within eye health.
    PLoS ONE 12/2013; 8(12):e81042. DOI:10.1371/journal.pone.0081042 · 3.23 Impact Factor
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