Relationships in Glaucoma Patients Between Standard Vision Tests, Quality of Life, and Ability to Perform Daily Activities

Purpose: To determine the relationships among three methods of assessing visual loss caused by glaucoma: (1) standard clinical tests of vision, (2) self-reported quality of life, and (3) the ability to perform activities of daily living. Methods: One hundred and ninety two glaucoma patients with a full range of glaucomatous visual loss were selected from the Glaucoma Service of Wills Eye Institute. Subjects were evaluated clinically by visual acuity, contrast sensitivity, visual field, stereopsis, the Disc Damage Likelihood Scale, and intraocular pressure. Subjects were evaluated subjectively by the 25-item National Eye Institute's Visual Functioning Questionnaire (NEI-VFQ-25) and objectively by a performance-based measure of visual function, the Assessment of Disability Related to Vision (ADREV). Statistical analysis, including Spearman coefficients, was performed on the data from the clinical measures, NEI-VFQ-25, and ADREV. Results: The clinical tests had higher correlations with ADREV than with the NEI-VFQ-25. There was a moderate, but not strong, connection between how patients rated their own visual ability with how they performed when objectively tested. Conclusions: ADREV provides valid estimates of how visual loss due to glaucoma affects the ability to perform activities of daily living. Performance-based testing and quality of life evaluations are both independently important measures of health, which are related, but by no means the same.