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(Investigative Ophthalmology and Visual Science. 2004;45:71-76.)
© 2004 by The Association for Research in Vision and Ophthalmology, Inc.
doi:10.1167/iovs.03-0661
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Impact of Bilateral Visual Impairment on Health-Related Quality of Life: the Blue Mountains Eye Study

Ee-Munn Chia,1 Jie Jin Wang,1 Elena Rochtchina,1 Wayne Smith,2 Robert R. Cumming,3,4 and Paul Mitchell1

1From the Department of Ophthalmology and the 3School of Public Health, University of Sydney, Sydney, Australia; the 2Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, Newcastle, Australia; and the 4Centre for Education and Research, Concord Hospital and University of Sydney, Australia.

PURPOSE. To assess the impact of visual impairment on health-related quality of life (HRQOL) in an older population and compare it with the impact of major medical conditions.

METHODS. Participants of the second cross-sectional Blue Mountains Eye Study (BMES; n = 3509; mean age, 66.7 years; 57% female) were asked to complete the self-administered 36-item Short-Form health survey (SF-36), a comprehensive interview, and an eye examination. Visual impairment was defined as visual acuity less than 20/40 (better eye).

RESULTS. Of 3154 (89.9%) participants with complete data, 172 (5.5%) had visual impairment due to refractive errors (correctable visual impairment) and 66 (2.1%) due to eye conditions (noncorrectable visual impairment; 49 mild, 9 moderate, 8 severe). After adjustment for demographic and medical confounders, there was a trend toward lower SF-36 scores in participants with noncorrectable impairment than in those with correctable impairment (physical component score [PCS] Ptrend = 0.01 and mental component score [MCS] Ptrend = 0.02). Increasingly severe noncorrectable visual impairment was associated with significantly poorer SF-36 scores in all but two dimensions. The impact of noncorrectable visual impairment was comparable to that from major medical conditions (e.g., stroke) and had a greater impact on mental than physical domains (mean MCS = 46.2, PCS = 41). No significant differences in HRQOL were demonstrated between visual impairment cases caused by age-related maculopathy and cataract, after adjusting for severity of visual impairment.

CONCLUSIONS. Noncorrectable visual impairment was associated with reduced functional status and well-being, with a magnitude comparable to major medical conditions. These data have implications for disability weights such as those developed by the Global Burden of Disease study.




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