The association of postoperative subjective visual function with acuity, glare, and contrast sensitivity in patients with early cataract
I. A. Adamsons, S. Vitale, W. J. Stark and G. S. Rubin
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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.
