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A qualitative investigation of visual tasks with which to assess distance-specific visual function

Abstract

Background

The ability to perform many daily tasks relies on good visual acuity at various distances. A review of existing measures of visual function revealed gaps in task content, particularly tasks that rely on intermediate vision.

Purpose

This research sought to extend the content base and visual range coverage of tasks used to assess visual function.

Methods

Ophthalmology patients (n = 72) with myopia, hyperopia, presbyopia, astigmatism, cataracts, and/or glaucoma were involved in various qualitative sub-studies, including life event journaling, telephone interviews, and both on-line and face-to-face focus groups. The resulting journal entries and transcripts were thematically analyzed to identify visual tasks that rely on visual acuity in the near, intermediate, and distant visual ranges.

Results

A wide variety of distance-specific visual tasks were identified. Certain types of tasks relied on distance vision, such as; ambulation, driving, leisure and sports, and social functions. Other task groupings such as technology use and activities of daily living relied primarily on near and intermediate vision. Two new content areas were identified, technology use and safe task performance.

Conclusions

This thematic analysis provides a rich body of information about tasks that affect daily life and are made more difficult by poor visual acuity at various distance ranges.

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Fig. 1

Notes

  1. The search strings are available as an on-line supplement.

  2. Information on measures associated with low vision or retinal problems such as age-related macular degeneration was not included in this table but is available on request.

  3. This information was collected and summarized following the US FDA Guidance on PRO instrument design and validation [39]. The project protocol was approved by the Institutional Review Board under the University of California, San Diego, Human Research Protection Program (Study Series 1: 081637; Study Series 2: 090116).

References

  1. Vitale, S., Ellwein, L., Cotch, M. F., Ferris, F. L., 3rd, & Sperduto, R. (2008). Prevalence of refractive error in the United States, 1999–2004. Archives of Ophthalmology, 126, 1111–1119.

    PubMed  Article  Google Scholar 

  2. Chalita, M. R., & Krueger, R. R. (2004). Correlation of aberrations with visual acuity and symptoms. Ophthalmology Clinics of North America 17, 135–142, v–vi.

    Google Scholar 

  3. Villa, C., Gutierrez, R., Jimenez, J. R., & Gonzalez-Meijome, J. M. (2007). Night vision disturbances after successful LASIK surgery. British Journal of Ophthalmology, 91, 1031–1037.

    PubMed  Article  Google Scholar 

  4. Long, G. M., & Garvey, P. M. (1988). The effects of target wavelength on dynamic visual acuity under photopic and scotopic viewing. Human Factors, 30, 3–13.

    PubMed  CAS  Google Scholar 

  5. Rosenberg, E. A., & Sperazza, L. C. (2008). The visually impaired patient. American Family Physician, 77, 1431–1436.

    PubMed  Google Scholar 

  6. Wong, T. Y., Foster, P. J., Johnson, G. J., & Seah, S. K. (2003). Refractive errors, axial ocular dimensions, and age-related cataracts: The Tanjong Pagar survey. Investigative Ophthalmology & Visual Science, 44, 1479–1485.

    Article  Google Scholar 

  7. Lee, A. J., Saw, S. M., Gazzard, G., Cheng, A., & Tan, D. T. (2004). Intraocular pressure associations with refractive error and axial length in children. British Journal of Ophthalmology, 88, 5–7.

    PubMed  Article  CAS  Google Scholar 

  8. Pande, A., et al. (2001). Crystal cataracts: human genetic cataract caused by protein crystallization. Proceedings of the National Academy of Sciences of the USA, 98, 6116–6120.

    PubMed  Article  CAS  Google Scholar 

  9. Kupfer, C. (2000). The National Eye Institute’s low vision education program: Improving quality of life. Ophthalmology, 107, 229–230.

    PubMed  Article  CAS  Google Scholar 

  10. Frost, N. A., et al. (1998). Development of a questionnaire for measurement of vision-related quality of life. Ophthalmic Epidemiology, 5, 185–210.

    PubMed  Article  CAS  Google Scholar 

  11. Mangione, C. M., et al. (2001). Development of the 25-item National Eye Institute Visual Function Questionnaire. Archives of Ophthalmology, 119, 1050–1058.

    PubMed  CAS  Google Scholar 

  12. Massof, R. W., & Rubin, G. S. (2001). Visual function assessment questionnaires. Survey of Ophthalmology, 45, 531–548.

    PubMed  Article  CAS  Google Scholar 

  13. Lamoureux, E. L., et al. (2008). An evaluation of the 10-item vision core measure 1 (VCM1) scale (the Core Module of the Vision-Related Quality of Life scale) using Rasch analysis. Ophthalmic Epidemiology, 15, 224–233.

    PubMed  Article  Google Scholar 

  14. Gupta, S. K., et al. (2005). The development of the Indian vision function questionnaire: Field testing and psychometric evaluation. British Journal of Ophthalmology, 89, 621–627.

    PubMed  Article  CAS  Google Scholar 

  15. Nelson, P., Aspinall, P., Papasouliotis, O., Worton, B., & O’Brien, C. (2003). Quality of life in glaucoma and its relationship with visual function. Journal of Glaucoma, 12, 139–150.

    PubMed  Article  Google Scholar 

  16. Mangione, C. M., et al. (1992). Development of the ‘Activities of Daily Vision Scale’. A measure of visual functional status. Medical Care, 30, 1111–1126.

    PubMed  Article  CAS  Google Scholar 

  17. Altangerel, U., Spaeth, G. L., & Steinmann, W. C. (2006). Assessment of Function Related to Vision (AFREV). Ophthalmic Epidemiology, 13, 67–80.

    PubMed  Article  Google Scholar 

  18. Hart, P. M., Stevenson, M. R., Montgomery, A. M., Muldrew, K. A., & Chakravarthy, U. (2005). Further validation of the Daily Living Tasks Dependent on Vision: Identification of domains. British Journal of Ophthalmology, 89, 1127–1130.

    PubMed  Article  CAS  Google Scholar 

  19. Bechetoille, A., et al. (2008). Measurement of health-related quality of life with glaucoma: Validation of the Glau-QoL 36-item questionnaire. Acta Ophthalmologica, 86, 71–80.

    PubMed  Article  Google Scholar 

  20. Terwee, C. B., Gerding, M. N., Dekker, F. W., Prummel, M. F., & Wiersinga, W. M. (1998). Development of a disease Specific Quality of Life Questionnaire for patients with Graves’ ophthalmopathy: The GO-QOL. British Journal of Ophthalmology, 82, 773–779.

    PubMed  Article  CAS  Google Scholar 

  21. Lee, B. L., et al. (1998). The Glaucoma Symptom Scale: A brief index of glaucoma-specific symptoms. Archives of Ophthalmology, 116, 861–866.

    PubMed  Article  CAS  Google Scholar 

  22. Burr, J. M., Kilonzo, M., Vale, L., & Ryan, M. (2007). Developing a preference-based Glaucoma Utility Index using a discrete choice experiment. Optometry and Vision Science, 84, 797–808.

    PubMed  Article  Google Scholar 

  23. Weih, L. M., Hassell, J. B., & Keeffe, J. (2002). Assessment of the impact of vision impairment. Investigative Ophthalmology & Visual Science, 43, 927–935.

    Google Scholar 

  24. Lamoureux, E. L., et al. (2007). The impact of vision impairment questionnaire: An assessment of its domain structure using confirmatory factor analysis and Rasch analysis. Investigative Ophthalmology & Visual Science, 48, 1001–1006.

    Article  Google Scholar 

  25. Owsley, C., McGwin, G. J., Scilley, K., & Kallies, K. (2006). Development of a questionnaire to assess vision problems under low luminance in age-related maculopathy. Investigative Ophthalmology & Visual Science, 47, 528–535.

    Article  Google Scholar 

  26. Hays, R. D., et al. (2003). Psychometric properties of the National Eye Institute-Refractive Error Quality of Life instrument. Ophthalmology, 110, 2292–2301.

    PubMed  Article  Google Scholar 

  27. Berry, S., Mangione, C. M., Lindblad, A. S., & McDonnell, P. J. (2003). Development of the National Eye Institute refractive error correction quality of life questionnaire: Focus groups. Ophthalmology, 110, 2285–2291.

    PubMed  Article  Google Scholar 

  28. Nichols, J. J., Mitchell, G. L., Saracino, M., & Zadnik, K. (2003). Reliability and validity of refractive error-specific quality-of-life instruments. Archives of Ophthalmology, 121, 1289–1296.

    PubMed  Article  Google Scholar 

  29. Dreer, L. E., et al. (2007). Development of a nursing home vision-targeted health-related quality of life questionnaire for older adults. Aging and Mental Health, 11, 722–733.

    PubMed  Article  CAS  Google Scholar 

  30. Schein, O. D. (2000). The measurement of patient-reported outcomes of refractive surgery: The refractive status and vision profile. Transactions of the American Ophthalmological Society, 98, 439–469.

    PubMed  CAS  Google Scholar 

  31. Garamendi, E., Pesudovs, K., Stevens, M. J., & Elliott, D. B. (2006). The Refractive Status and Vision Profile: Evaluation of psychometric properties and comparison of Rasch and summated Likert-scaling. Vision Research, 46, 1375–1383.

    PubMed  Article  Google Scholar 

  32. Janz, N. K., et al. (2001). Quality of life in newly diagnosed glaucoma patients: The Collaborative Initial Glaucoma Treatment Study. Ophthalmology 108, 887–97. Discussion 898.

    Google Scholar 

  33. du Toit, R., Palagyi, A., Ramke, J., Brian, G., & Lamoureux, E. L. (2008). Development and validation of a vision-specific quality-of-life questionnaire for Timor-Leste. Investigative Ophthalmology and Visual Science, 49, 4284–4289.

    Google Scholar 

  34. Pesudovs, K., & Coster, D. J. (1998). An instrument for assessment of subjective visual disability in cataract patients. British Journal of Ophthalmology, 82, 617–624.

    PubMed  Article  CAS  Google Scholar 

  35. Uusitalo, R. J., Brans, T., Pessi, T., & Tarkkanen, A. (1999). Evaluating cataract surgery gains by assessing patients’ quality of life using the VF-7. Journal of Cataract and Refractive Surgery, 25, 989–994.

    PubMed  Article  CAS  Google Scholar 

  36. Javitt, J. C., Jacobson, G., & Schiffman, R. M. (2003). Validity and reliability of the Cataract TyPE Spec: An instrument for measuring outcomes of cataract extraction. American Journal of Ophthalmology, 136, 285–290.

    PubMed  Article  Google Scholar 

  37. Lawrence, D. J., Brogan, C., Benjamin, L., Pickard, D., & Stewart-Brown, S. (1999). Measuring the effectiveness of cataract surgery: The reliability and validity of a visual function outcomes instrument. British Journal of Ophthalmology, 83, 66–70.

    PubMed  Article  CAS  Google Scholar 

  38. Mangione, C. M., et al. (1998). Psychometric properties of the National Eye Institute Visual Function Questionnaire (NEI-VFQ). NEI-VFQ Field Test Investigators. Archives of Ophthalmology, 116, 1496–1504.

    PubMed  CAS  Google Scholar 

  39. US Food and Drug Administration: Guidance for Industry. Patient-reported outcome measures: Use in medical product development to support labeling claims. http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM193282.pdf.

  40. Stone, A. A., Kessler, R. C., & Haythornthwaite, J. A. (1991). Measuring daily events and experiences: Decisions for the researcher. Journal of Personality, 59, 575–607.

    PubMed  Article  CAS  Google Scholar 

  41. National Eye Institute & Lions Clubs International Foundation. (2007). 2005 survey of public knowledge, attitudes, and practices related to eye health and disease. Bethesda, MD: National Eye Institute. Available at: http://www.nei.nih.gov/nehep/kap/.

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Acknowledgments

We would like to thank Charmie E. Chirgwin, RN, PRO-Spectus, Inc., San Diego, CA, for her supportive role with study management and patient recruitment. Funding for this research was provided by Alcon Research, Ltd.

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Correspondence to Mark J. Atkinson.

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Atkinson, M.J., Tally, S., Heichel, C.W. et al. A qualitative investigation of visual tasks with which to assess distance-specific visual function. Qual Life Res 22, 437–453 (2013). https://doi.org/10.1007/s11136-012-0154-2

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  • DOI: https://doi.org/10.1007/s11136-012-0154-2

Keywords

  • Ophthalmology
  • Vision
  • Qualitative methods
  • Ecological event monitoring
  • Life experience sampling
  • Focus groups
  • Content validity
  • Visual acuity
  • Refractive error
  • Visual function