Br J Ophthalmol 1999;83:792-795 ( July )
Creation and testing of a practical visual function assessment
for use in Africa: correlation with visual acuity, contrast
sensitivity, and near vision in Malawian adults
Karin van Dijka, Susan Lewallenb, Moses Chiramboc, Jane Gardinerb, Brian Hoarb, Janette Lindleyb, N Kevin Wadeb, Paul Courtrightb
a Christoffel
Blindenmission, Boshof 10, 7873 AC Odoorn, Netherlands, b BC Centre for Epidemiologic and
International Ophthalmology, University of British Columbia, St Paul's
Hospital, Vancouver, Canada, c Sight Savers International, PO Box 30858, Lilongwe, 3, Malawi
Correspondence to: Dr Paul Courtright, BC Centre for Epidemiologic and International
Ophthalmology, St Paul's Hospital, 1081 Burrard Street, Vancouver, BC
V6Z 1Y6, Canada.
Accepted for publication 27 January 1999
AIM To develop and
test a practical visual function assessment for use in developing countries.
METHODSUsing focus
group discussions and interviews with eyecare workers and low vision
specialists in Malawi, 13 questions related to visual characteristics
of activities of daily living were designed. Patients presenting to an
eye clinic were recruited and interviewed. Visual acuity, near vision,
and contrast sensitivity were measured. Analysis sought to determine
the degree of correlation between the vision indices and visual function.
RESULTSThe visual
function questionnaire was easy to administer. Visual function
correlated with visual acuity, contrast sensitivity, near vision, and
patient reported visual problem. People with a higher frequency of
"not applicable" responses had lower visual function scores.
Multivariate modelling revealed that visual acuity and number of
questions felt to be applicable were independently associated with
visual function. Reducing the questionnaire to nine questions did not
affect the degree of correlation with any of the visual indices.
CONCLUSIONThe
authors' visual function assessment correlates well with different
measures of visual acuity. People with reduced vision for a prolonged
period may no longer consider doing certain tasks and the number of
questions considered appropriate by an individual may be an additional
measure of visual function. Assessment of visual function by health
workers may be a valuable tool in improving surgical uptake by
encouraging both health personnel and patients to recognise that they
have difficulties undertaking activities of daily living as well as a
measure of monitoring and evaluating cataract outcomes.
© 1999 by British Journal of Ophthalmology
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