The Relationship Between Lighting and Clinical Measures of Visual Function at Home and in the Clinic in Normal and Glaucoma Participants

Abstract

Purpose: : To determine whether lighting and clinical measures of visual function differ between the home and clinic setting in normal and glaucoma participants.

Methods: : Consecutive eligible patients with glaucoma and age and gender matched normal patients were enrolled in the study. Participants completed a home and clinic visit randomized with respect to order of completion. Certified examiners administered the ETDRS distance visual acuity, Lighthouse near visual acuity, Pelli-Robson contrast sensitivity, and Brightness Acuity Tester (low and medium settings) at each visit. Illumination of each chart was measured with a light meter at the home and clinic visits. Wilcoxon rank sum test was used to compare home and clinic illumination and clinical measures of visual function.

Results: : 103 glaucoma participants with a mean age of 73.0 ± 8.0 years and 26 normal participants with a mean age of 74.4 ± 6.4 years completed both a home and clinic visit. Illumination and performance on all clinical measures were significantly higher in the clinic than in the home in both groups (p<0.05, Wilcoxon rank sum test).

Conclusions: : Performance on clinical measures of visual function was better in the clinic than in the home in both glaucoma and normal participants. Illumination was substantially higher in the clinic than in the home. Clinicians should be aware that clinical measures tested in the clinic may not accurately reflect visual function of patients in their home setting. An improvement in home lighting may improve visual function of older glaucoma and normal patients.

Keywords: brightness and lightness • aging: visual performance • quality of life