Abstract
Purpose: :
To determine if the healthier or more diseased eye has more influence on people’s ability to function in daily life.
Methods: :
194 glaucoma patients, 112 macular degeneration patients, 91 diabetic retinopathy patients, and 98 controls were evaluated by standard clinical measures of vision in each eye. The clinical test scores of each eye were compared to subject’s ability to perform daily activities, which was measured by a novel, third-generation performance-based instrument titled ADREV (Assessment of Disability Related to Vision). The clinical tests were also compared to a vision-specific quality of life indicator, the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25).
Results: :
In glaucoma patients, the mean deviation of the better eye had a higher correlation (p < 0.05) than the mean deviation of the worse eye with the ADREV score. In macular degeneration patients, the eye with better visual acuity had a higher correlation (p < 0.01) with the ADREV score when compared to the eye with worse visual acuity. In diabetic retinopathy patients, the eye with higher visual acuity had a higher correlation (not significant) than the eye with worse visual acuity with the ADREV score. The controls’ correlations did not have a difference between the better and worse eye. In each group of subjects, there was no difference between the better and worse eye when comparing the clinical tests to quality of life.
Conclusions: :
In glaucoma, macular degeneration, and diabetic retinopathy patients, the healthier eye has a greater influence on patients’ ability to function than the more diseased eye when considering the entire spectrum of disease severity. Pateints’ beliefs of their quality of life are not influenced more heavily by either the better or worse eye. When caring for patients, it is vitally important to carefully examine the healthier eye, and not to solely focus on the more diseased eye.
Keywords: aging: visual performance • quality of life • clinical (human) or epidemiologic studies: natural history