title: Visual functioning and quality of life outcomes among cataract operated and unoperated blind populations in Nepal.
abstract: BACKGROUND
  Visual acuity and vision related quality of life outcomes in cataract surgery were evaluated in a population based survey in two geographic zones in Nepal.
  
  
  METHODS
  Case finding was based on random sampling using a stratified cluster design with door to door enumeration of people aged > or = 45 years followed by eye examinations at village sites. All aphakics/pseudophakics, those with visual acuity less than 6/60 in either eye, and a sample of those with normal visual acuity were administered visual functioning (VF) and quality of life (QOL) questionnaires.
  
  
  RESULTS
  15% of the 159 cataract operated cases had presenting visual acuity > or = 6/18 in both eyes, 38% with best corrected visual acuity. 21% were still blind with presenting visual acuity < 6/60 in both eyes, 7% with best correction. On a 0-100 scale, mean VF and QOL scores were 87.2 and 93.9 respectively in normally sighted unoperated individuals, dropping to 15.6 and 29.5 for those severely blind (< 3/60). Among the cataract operated, mean VF and QOL scores were 47.5 and 55.4, respectively. VF and QOL scores correlated with vision status at statistically significant levels (p < 0.0001).
  
  
  CONCLUSIONS
  Cataract surgery outcomes, whether measured by traditional visual acuity or by patient reported VF/QOL, are at levels many would consider unacceptably low. It is apparent that in the quest to reduce cataract blindness much more attention must be given to improving surgery outcomes.
authors.affiliation: Foundation Eye Care Himalaya, Kathmandu, Nepal.
authors.forename: G P
authors.initials: GP
authors.lastname: Pokharel
authors.forename: S
authors.initials: S
authors.lastname: Selvaraj
authors.forename: L B
authors.initials: LB
authors.lastname: Ellwein
mesh_terms: D000368:Aged; D001766:Blindness / Q000453:epidemiology / Q000503:physiopathology / Q000601:surgery*; D002386:Cataract / Q000453:epidemiology / Q000503:physiopathology*; D002387:Cataract Extraction; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009390:Nepal / Q000453:epidemiology; D011785:Quality Assurance, Health Care; D011788:Quality of Life; D012029:Refraction, Ocular; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology