title: Visual function and quality of life among visually impaired and cataract operated adults. The Pakistan National Blindness and Visual Impairment Survey.
abstract: OBJECTIVE
  To assess visual functioning and quality of life in a representative sample of normally sighted, visually impaired and cataract operated individuals aged >or= 30 years in Pakistan.
  
  
  METHODS
  As part of the Pakistan National Blindness and Visual Impairment Survey, visual functioning (VF) and quality of life (QOL) questionnaires were administered to participants with presenting visual acuity less than 6/60 in either eye, aphakes/pseudophakes and a phakic sample with normal acuity (>or= 6/12 both eyes).
  
  
  RESULTS
  Of 16,507 adults included in the survey, 2329 questionnaires were administered. There were strong correlations between visual acuity and VF/QOL. Mean VF and median QOL scores in normally sighted phakic individuals were 81.1 and 88.9, respectively, but were only 34.8 and 64.9 in blind unoperated individuals. In the cataract operated population overall mean VF and median QOL scores were 49.3 and 75.0. Both VF and QOL scores were lower in operated individuals than unoperated individuals (p < 0.001). Among operated individuals, rural dwelling and illiteracy were associated with lower VF and QOL scores (p all < 0.02). Although in multivariable analysis bilateral pseudophakes had similar VF scores to bilateral aphakes they had significantly better QOL scores (p = 0.001).
  
  
  CONCLUSIONS
  Cataract surgery in Pakistan has not led to VF and QOL scores equivalent to those in unoperated individuals with the same levels of visual acuity. The higher proportion of intraocular lens surgery in recent years is likely to improve QOL following cataract surgery. Further focus is needed on rural and illiterate populations, to ensure that they achieve comparable VF/QOL outcomes following surgery.
authors.affiliation: International Centre for Eye Health, School of Hygiene and Tropical Medicine, London, United Kingdom. amy.taylor@lshtm.ac.uk
authors.forename: Amy E
authors.initials: AE
authors.lastname: Taylor
authors.forename: Shaheen P
authors.initials: SP
authors.lastname: Shah
authors.forename: Clare E
authors.initials: CE
authors.lastname: Gilbert
authors.forename: Mohammad Z
authors.initials: MZ
authors.lastname: Jadoon
authors.forename: Rupert R A
authors.initials: RR
authors.lastname: Bourne
authors.forename: Brendan
authors.initials: B
authors.lastname: Dineen
authors.forename: Gordon J
authors.initials: GJ
authors.lastname: Johnson
authors.forename: Mohammad D
authors.initials: MD
authors.lastname: Khan
mesh_terms: D000328:Adult; D000368:Aged; D001036:Aphakia, Postcataract / Q000453:epidemiology*; D001766:Blindness / Q000453:epidemiology*; D002387:Cataract Extraction; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D019591:Pseudophakia / Q000453:epidemiology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*