Vision change and quality of life in the elderly. Response to cataract surgery and treatment of other chronic ocular conditions
M. H. Brenner, B. Curbow, J. C. Javitt, M. W. Legro and A. Sommer
School of Hygiene and Public Health, Johns Hopkins University, Baltimore, Md.
OBJECTIVE--Evaluation of health care in older populations has increasingly
focused on quality of life as a critical outcome of treatment. Vision is
assumed to be central to functioning. Data suggest that aging, in itself,
is associated with a decline in visual functioning, which, in turn, is
related to a decline in physical and mental functioning. Other studies
indicate that cataract surgery is followed by significant improvement in
vision and visual function. Our objective was to test these assumptions.
DESIGN--Prospective study of 1021 patients, consecutively drawn from 76
randomly selected ophthalmologists' offices in three cities. Structured
interviews were completed at baseline, 2 months, and 1 year after entry.
PATIENTS--Six hundred thirteen patients with cataracts and 408 other
ophthalmic patients drawn from the same offices but treated for other
chronic ocular disorders. All received refractive services as needed.
SETTING--Patients from three cities (Baltimore, Md, St Louis, Mo, and San
Diego, Calif) were interviewed once in their homes and twice by telephone.
INTERVENTIONS--The study involved the measurement of the effects of usual
treatment for cataracts and other degenerative eye diseases. MAJOR OUTCOME
MEASURES--Visual, social, and psychological functioning. RESULTS--Within 1
year of treatment, change in visual function was accompanied by significant
changes, in the same direction, in quality of life functions: night-time
driving, daytime driving, community activities, home activities, mental
health, and life satisfaction. In addition, the patients with cataracts
showed significantly greater improvement in measures of vision than did the
noncataract group. CONCLUSIONS--Regardless of treatment, improvement across
quality of life functions occurred when visual function improved. Thus,
many types of functional degeneration observed in older populations,
attributed to a decline in vision, can be slowed, or even reversed, when
visual function is improved. Cataract surgery was effective in improving
vision and quality of life functions.
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Wood and Carberry
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van Dijk et al.
Br. J. Ophthalmol. 1999;83:792-795.
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The need for cataract surgery: projections based on lens opacity, visual acuity, and personal concern
McCarty et al.
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Mangione et al.
Arch Ophthalmol 1998;116:1496-1504.
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Williams et al.
Arch Ophthalmol 1998;116:514-520.
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Mangione et al.
Arch Ophthalmol 1998;116:227-233.
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Elliott et al.
Br. J. Ophthalmol. 1997;81:889-895.
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The Eyes have it: Cataract Surgery and Changing Patterns of Outpatient Surgery
Meddings et al.
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