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Anjali M. Bhorade, Monica Perlmutter, Brad Wilson, Sidney T. Chang, Melike Pekmezci, Jamie Kambarian, Mae Gordon; A Comparison Of Visual Acuity, Contrast Sensitivity, And Glare Testing Between Clinic And Home In Patients With And Without Glaucoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5553.
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To determine if vision tested in the clinic accurately reflects vision in the home in patients with and without glaucoma.
Glaucoma patients, ages 55-90 years, and normal age-matched controls were consecutively recruited. Participants underwent a home and clinic visit randomized to order of completion. A certified examiner measured bilateral ETDRS distance visual acuity (VA), Lighthouse near VA, Pelli-Robson contrast sensitivity, and glare using medium brightness acuity testers at each visit. Lighting levels (lux) in the home and clinic were measured using a light meter. Factors associated with differences in vision testing between home and clinic were analyzed.
138 glaucoma (mean age 72.7± 7.8 years) and 52 normal (mean age 70.9± 8.0 years) participants completed both home and clinic visits. Glaucoma and normal participants performed worse in home than clinic on all vision tests with statistically significant differences for ETDRS, Pelli-Robson, and glare (p=0.009 to <0.0001). Approximately one-third of glaucoma and normal participants performed greater than or equal to 1 line worse at home than clinic on near and distance VA and approximately one-half of glaucoma and normal participants perfomed greater than or equal to 2 triplets worse at home than clinic on medium glare testing (Table). Lighting was significantly lower in the home than clinic for all participants (mean lux 135.5 + 176.1 in home vs. mean lux 439.0 ± 450.2 in clinic, p <0.0001) and was the factor most closely associated with differences in vision testing between home and clinic (multivariate regression model, p<0.05).
Visual acuity, contrast sensitivity, and glare may be worse at home than tested in clinic for patients with and without glaucoma. Lighting is a modifiable factor that may improve visual function in the home.
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