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K. A. Schoessow; Differences in Perception of Function Between Older Adults With Glaucoma and Their Spouses. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4717.
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© ARVO (1962-2015); The Authors (2016-present)
Social support assists people with low vision in participating in meaningful activities, yet can lead to negative consequences if caregivers misjudge the functional ability of the person with low vision and thus are either overprotective or demanding. This study examined whether people with glaucoma’s self-perception of function differs from the observation of their spouse.
Participants were recruited through an ophthalmology clinic, were aged 60-90, had a diagnosis of glaucoma, and lived with a spouse. Those with a co-morbidity capable of affecting visual fields were excluded. Controls had the same criteria, but without glaucoma.An OT graduate student conducted a home visit to measure visual acuity (VA) and contrast sensitivity (CS) for the participants with glaucoma and interview them and their spouses, using the NEI-VFQ and Driving Habits Questionnaire (DHQ). Items were altered for the spouse to reflect perspective. Visual fields were assessed during ophthalmic exam at the recruitment visit.
Participants were grouped by glaucoma severity: mild (n=12), moderate (n=11), severe (n=7). Participants averaged near-normal VA and CS. Visual fields declined across severity levels. On the DHQ, both participants with glaucoma (F=7.381, p<.01) and spouses (F=3.802, p<.05) identified declines in driving ability across glaucoma stages. Spousal scores were also similar for NEI-VFQ subscales involving ADLs: both groups identified decreased function as glaucoma progressed (p<.05). Spousal responses differed on the Role Difficulties (F=3.224, p<.05) and Dependency (F=10.338, p<.001) subscales. Participants with glaucoma responded that they are more independent and better maintaining life roles than their spouses said they are.
Participants with glaucoma and their spouses agreed that functional declines in driving and ADLs occur as glaucoma progresses. Spouses were less aware of psychological adjustment to vision loss, tending to give more impaired ratings than participants with glaucoma gave themselves. This disconnect between spouses can lead to negative psychosocial consequences within the home and thus excess disability for the person with low vision. This study provides support for occupational therapists to address patients’ psychological status and social environment.
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