Br J Ophthalmol 1998;82:606-610 ( June )
Visual functioning and quality of life outcomes among cataract
operated and unoperated blind populations in Nepal
G P Pokharel,a
S Selvaraj,b
Leon B Ellweinc
a Foundation Eye Care Himalaya, Kathmandu, Nepal, b Aravind Eye Hospital, Madurai, India, c National Eye Institute, Bethesda, Maryland,
USA
Correspondence to: Leon B
Ellwein, PhD, National Eye Institute, 31 Center Drive, MSC 2510, Bldg
31, Rm 6A-04, Bethesda, MD 20892-2510, USA.
Accepted for publication 9 January 1998
BACKGROUND Visual acuity and vision related
quality of life outcomes in cataract surgery were evaluated in a
population based survey in two geographic zones in Nepal.
METHODSCase finding was based on random sampling
using a stratified cluster design with door to door enumeration of
people aged  45 years followed by eye examinations at village sites.
All aphakics/pseudophakics, those with visual acuity less than 6/60 in
either eye, and a sample of those with normal visual acuity were
administered visual functioning (VF) and quality of life (QOL) questionnaires.
RESULTS15% of the 159 cataract operated cases
had presenting visual acuity 6/18 in both eyes, 38% with best
corrected visual acuity. 21% were still blind with presenting visual
acuity <6/60 in both eyes, 7% with best correction. On a 0-100
scale, mean VF and QOL scores were 87.2 and 93.9 respectively in
normally sighted unoperated individuals, dropping to 15.6 and 29.5 for
those severely blind (<3/60). Among the cataract operated, mean VF and
QOL scores were 47.5 and 55.4, respectively. VF and QOL scores
correlated with vision status at statistically significant levels (p
<0.0001)
CONCLUSIONCataract surgery outcomes, whether
measured by traditional visual acuity or by patient reported VF/QOL,
are at levels many would consider unacceptably low. It is apparent that
in the quest to reduce cataract blindness much more attention must be
given to improving surgery outcomes.
Keywords:
cataract surgery;
visual acuity;
visual functioning;
quality of life
© 1998 by British Journal of Ophthalmology
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