Quality of life of the most severely vision-impaired.
BACKGROUND
To explore the interaction between vision impairment, perceived quality of life loss and willingness to trade remaining life for vision gain.


METHODS
Community-based cross-sectional study.


METHODS
Legally blind or severely vision-impaired people selected randomly from the Association for the Blind of Western Australia register.


METHODS
Individuals were examined by consultant ophthalmologists and completed the Impact of Vision Impairment profile quality of life assessment and a Time Trade-Off evaluation. Vision-related utility values were calculated. The results were analysed using univariate and multivariate regression methods.


METHODS
IVI Rasch Logits and TTO utility values (TTO UV).


RESULTS
156 people volunteered to contribute to the study. The median age was 80 (19-97) years, and 56% were female. Being legally blind (logMAR > 1) (95% CI 1.1 to 5.2, P = 0.003), clinically depressed (95% CI -11.2 to -1.8, P = 0.007) or more than 40 years of age (95% CI 0.9 to 8.1, P = 0.015) significantly lowered overall impact of vision impairment scores. The emotional domain of impact of vision impairment was associated with willingness to trade part of remaining life. A 5-Logit increase in impact of vision impairment emotional score resulted in a 21% (95% CI 10 to 31) decrease in the odds of being likely to trade life for sight. The Australian definition of blindness compared with World Health Organisation or USA best separates those with perceived loss and appears useful in identifying vision loss-related morbidity.


CONCLUSIONS
These results suggest that emotional health and lack of depression are important determinants for quality and value of life.
Centre for Population Health Research, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia, Australia. j.crewe@curtin.edu.au
Julie M
JM
Crewe
Nigel
N
Morlet
William H
WH
Morgan
Katrina
K
Spilsbury
Aqif
A
Mukhtar
Antony
A
Clark
Jonathon Q
JQ
Ng
Margaret
M
Crowley
James B
JB
Semmens
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000191:economics / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D012042:Registries; D015354:Vision, Low / Q000191:economics / Q000523:psychology*; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000523:psychology*; D014904:Western Australia; D055815:Young Adult