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Ingrid A. Adamsons, MD, MPH; Susan Vitale, MHS; Walter J. Stark, MD; Gary S. Rubin, PhD

Arch Ophthalmol. 1996;114(5):529-536.

Abstract
Background
It has been shown in our previous studies that early cataracts affect vision in ways that can be measured by objective means and that this objective impairment in visual acuity, glare, and contrast sensitivity can be successfully reversed by cataract surgery.

Objective
To evaluate the association of subjective visual function with objective measures of acuity, glare, and contrast sensitivity in patients who were symptomatic from early cataract.

Methods
We administered a task-oriented questionnaire prior to and 4 months after cataract surgery to patients who were symptomatic from early cataract (median preoperative ETDRS [Early Treatment Diabetic Retinopathy Study] visual acuity of 20/40 [range, 20/20 to 20/80]); ETDRS visual acuity, disability glare, and contrast sensitivity were also measured at those times.

Results
Uncomplicated cataract surgery resulted in resolution or improvement of subjective symptoms for the great majority of subjects, and in a few subjects new symptoms developed or current symptoms worsened. We found a positive association between postoperative improvement in subjective visual function (as measured by the questionnaire) and postoperative improvement in objective visual function (as measured by visual acuity and contrast sensitivity). We also found that the greater the degree of preoperative impairment in objective visual function (as measured by visual acuity and contrast sensitivity), the greater the postoperative improvement in subjective visual function (as measured by the questionnaire). No such association was found for our disability glare test.

Conclusions
Cataract surgery for symptomatic individuals with mild impairment in visual acuity does relieve visual symptoms, and preoperative measurement of contrast sensitivity can help determine who with early cataract is most likely to report subjective improvement in vision.

Author Affiliations
From The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Md. Dr Adamsons is currently with MERCK Research Laboratories, Blue Bell, Pa.

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