title: Correctable visual impairment and its impact on quality of life in a marginalized Canadian neighbourhood.
abstract: OBJECTIVE
  To study the impact of visual impairment due to either underlying ocular pathology or easily correctable refractive error on vision-related functioning and quality of life (QOL) in Vancouver's downtown eastside (VDES).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Two hundred consecutive patients seeking general medical care at the Vancouver Native Health Society (VNHS) medical clinic were included.
  
  
  METHODS
  An ocular examination was performed and a standardized history and QOL information were obtained for each participant. Effective visual impairment was classified based on patients' current refractive means. Pathological visual impairment was classified based on patients' best-corrected visual acuity (VA). Vision-related functioning was quantified using the Daily Tasks Dependent on Vision (DTDV) questionnaire. Health-related QOL was assessed using the 12-Item Short Form Health Survey (SF-12).
  
  
  RESULTS
  Two hundred patients participated; they suffered, on average, 6.2 comorbid conditions. Sixty-two patients (31%) were effectively visually impaired and, of these, 14 patients (7%) were effectively blind. Ten patients (5%) had pathological eye disease to explain their visual impairment. The remaining 52 visually impaired patients (26%) had VA that normalized with correction. Difficulty with the tasks described in the DTDV questions was significantly correlated with effective visual impairment. Patients with effective visual impairment had lower Physical Composite Scores on the SF-12 in multivariate analyses.
  
  
  CONCLUSIONS
  We have demonstrated a very high rate of visual impairment in a low socioeconomic population that is associated with decreased vision-dependent functioning and decreased overall physical health status. Public health efforts need to be directed toward improving easily correctable refractive error.
authors.affiliation: Department of Ophthalmology, Queen's University, Kingston, Ont.
authors.forename: Hussein
authors.initials: H
authors.lastname: Hollands
authors.forename: Anya C
authors.initials: AC
authors.lastname: Brox
authors.forename: Angela
authors.initials: A
authors.lastname: Chang
authors.forename: Steve
authors.initials: S
authors.lastname: Adilman
authors.forename: Bubli
authors.initials: B
authors.lastname: Chakraborti
authors.forename: Gordon
authors.initials: G
authors.lastname: Kliever
authors.forename: David A L
authors.initials: DA
authors.lastname: Maberley
mesh_terms: D000203:Activities of Daily Living; D001766:Blindness / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D001955:British Columbia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty; D015995:Prevalence; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data; D015354:Vision, Low / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D014792:Visual Acuity; D019987:Persons with Visual Disabilities / Q000523:psychology*