Correctable visual impairment and its impact on quality of life in a marginalized Canadian neighbourhood.
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.
Hollands
Hussein
H
Department of Ophthalmology, Queen's University, Kingston, Ont.
Brox
Anya C
AC
Chang
Angela
A
Adilman
Steve
S
Chakraborti
Bubli
B
Kliever
Gordon
G
Maberley
David A L
DA
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*