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J. A. Rosdahl, M. L. Jackson; Comparison of Visual Function and Inventory of Vision Impairment Scores of Patients With Glaucoma and Patients With Age-Related Macular Degeneration Who Are Referred for Vision Rehabilitation. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3769.
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Age-related macular degeneration (AMD) and glaucoma are important causes of visual impairment in our aging population. We performed a chart review of patients referred to our Vision Rehabilitation Service at the Massachusetts Eye and Ear Infirmary (MEEI) to compare the measured visual functioning and effect of visual impairment on activities of daily living in patients with glaucoma compared to those with AMD.
The charts of patients who were referred to the MEEI Visual Rehabilitation Service with a primary diagnosis of either AMD or glaucoma who had also completed an Impact of Vision Impairment (IVI) Profile during a four month period were reviewed. The IVI Profile is a survey of 28 questions designed to measure the impact of visual impairment on a patient’s day-to-day function. The IVI scores were grouped in three domains, Mobility and Independence, Reading and Accessing Information, and Emotional Well-being.
A total of 46 patients were reviewed (35 with AMD versus 11 with glaucoma). Patients referred with a diagnosis of glaucoma were significantly younger (68 versus 83). As would be anticipated, the patients with glaucoma had better visual acuity (logMAR -0.48 in glaucoma versus -0.70 in AMD). Contrast sensitivity was higher in the patients with glaucoma, although it was lower than normal (1.45 in glaucoma versus 0.98 in AMD; normal is 1.65 log on Pelli Robson testing). Patients with glaucoma had better scores for Reading and Accessing Information (group total 15.2 in AMD versus 10.2 in glaucoma). There were statistically significant differences between the glaucoma patients’ and the AMD patients’ scores on the individual questions in the Reading domain. The two groups scored similarly at Mobility and Independence questions and at Emotional Well-being questions.
In this population of patients referred for Vision Rehabilitation, patients with glaucoma had better visual acuity, better contrast sensitivity, and better Reading and Accessing Information Skills. However, despite the retained central visual acuity, they score similarly to the patients with AMD at Mobility and Emotional Well-being. The retained Mobility score of patients with AMD is likely due to presumed preservation of peripheral vision. Both groups answered that they had some difficulty dealing with the emotional aspects of their vision loss, suggesting that the preserved visual acuity of the glaucoma patients was not protective.
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