title: Impact of severity and bilaterality of visual impairment on health-related quality of life.
abstract: OBJECTIVE
  To assess the impact of unilateral and bilateral visual impairment (VI) and its severity on health-related quality of life (HRQOL) in Latinos 40 years and older.
  
  
  METHODS
  A cross-sectional population-based study, the Los Angeles Latino Eye Study (LALES).
  
  
  METHODS
  Five thousand three hundred seventy-seven LALES participants.
  
  
  METHODS
  Health-related quality of life was measured by the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the Medical Outcomes Study 12-Item Short Form Health Survey (SF-12). Visual acuity (VA) was measured by a standardized protocol. Based on the presenting VA, VI was classified as unilateral or bilateral impairment and as either mild (20/40-20/63) or moderate/severe (20/80 or worse).
  
  
  METHODS
  National Eye Institute VFQ-25 and SF-12 composite and subscale scores.
  
  
  RESULTS
  The NEI VFQ mean composite score decreased from no VI (86) to bilateral moderate/severe VI (66) (P<0.006). Relative to participants with no VI, those with unilateral or bilateral VI at any severity level had significantly lower NEI VFQ-25 scores for 10 of the 12 subscales (P<0.05). The largest mean score differences between participants with and without VI were observed for subscales related to driving difficulties (42.5 points), vision-related dependency (29.1 points), distance vision (27.0 points), and vision-related mental health (24.5 points). No differences in SF-12 scores were found between participants with and without VI (P>0.05).
  
  
  CONCLUSIONS
  Relative to persons with no VI, persons with bilateral mild and unilateral or bilateral moderate/severe VI report greater difficulties in performing most vision-dependent daily activities and experience vision-related dependency and poorer vision-related mental health. Because most visual function subscale scores were significantly lower in persons with bilateral mild and/or unilateral/bilateral moderate/severe VI, health care providers should consider intervention in these persons. Our findings provide further insight into the relationship between severity level, bilaterality of VI, and self-reported visual function. These data can be used to refine the determination of visual disability in persons with VI.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA. rvarma@usc.edu
authors.forename: Rohit
authors.initials: R
authors.lastname: Varma
authors.forename: Joanne
authors.initials: J
authors.lastname: Wu
authors.forename: Kelly
authors.initials: K
authors.lastname: Chong
authors.forename: Stanley P
authors.initials: SP
authors.lastname: Azen
authors.forename: Ron D
authors.initials: RD
authors.lastname: Hays
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D007839:Functional Laterality; D006304:Health Status; D006630:Hispanic or Latino / Q000208:ethnology; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000208:ethnology / Q000523:psychology*; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000523:psychology* / Q000706:statistics & numerical data