title: Vision impairment and major eye diseases reduce vision-specific emotional well-being in a Chinese population.
abstract: To assess the relationship between vision impairment (VI) and major eye diseases, with vision-specific emotional well-being in a Chinese population.
  
  
  
  In this population-based cross-sectional study, 3353 Chinese participants aged 40-80 years answered the emotional well-being scale of the Impact of Vision Impairment questionnaire, validated using Rasch analysis. Participants underwent visual acuity testing and collection of sociodemographic and medical data from standardised questionnaires. The relationships between presenting bilateral VI, presence of major eye diseases (cataract, undercorrected refractive error, glaucoma, age-related macular degeneration and diabetic retinopathy) and emotional well-being were assessed using linear regression models. Stratified analyses for age, gender, education and immigration status were conducted to determine if change in β coefficients differed within each stratum.
  
  
  
  Approximately half of patients (n=1805) had normal vision, and 43% (n=1534) and 3.4% (n=114) had moderate and severe bilateral VI, respectively. Vision-specific emotional well-being systematically worsened as severity of bilateral VI increased (p<0.001). Compared with no VI and no eye diseases, respectively, severe bilateral VI (23%; β -1.84; 95% CI -2.23 to -1.43) and glaucoma (β -1.88; 95% CI -3.00 to -0.76) were associated with a clinically meaningful reduction in emotional well-being. The reduction in vision-related emotional well-being was substantially and significantly greater in men compared with women (p<0.05).
  
  
  
  Severe VI and glaucoma are associated with substantial decrements in vision-specific emotional well-being, highlighting the importance of preventing progression of vision loss. Evidence-based interventions to improve vision-related coping skills and emotional management for patients with severe VI and glaucoma are warranted.
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.|Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, Victoria, Australia.|Duke-NUS Medical School, Singapore, Singapore.
authors: Eva K
authors: EK
authors: Fenwick
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
authors: Peng Guan
authors: PG
authors: Ong
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.
authors: Ryan E K
authors: REK
authors: Man
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.|Duke-NUS Medical School, Singapore, Singapore.
authors: Charumathi
authors: 0000-0002-4042-4719
authors: C
authors: Sabanayagam
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.|Duke-NUS Medical School, Singapore, Singapore.|Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore.
authors: Ching-Yu
authors: CY
authors: Cheng
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.|Duke-NUS Medical School, Singapore, Singapore.|Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore.
authors: Tien Y
authors: TY
authors: Wong
authors: Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore.|Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, University of Melbourne, East Melbourne, Victoria, Australia.|Duke-NUS Medical School, Singapore, Singapore.|Department of Ophthalmology, National University of Singapore and National University Health System, Singapore, Singapore.
authors: Ecosse L
authors: EL
authors: Lamoureux
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D044466:Asian People; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005128:Eye Diseases / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D018434:Sickness Impact Profile; D014786:Vision Disorders / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D014792:Visual Acuity; D019987:Persons with Visual Disabilities / Q000523:psychology / Q000706:statistics & numerical data
keywords: Epidemiology; Glaucoma; Public health; Vision