Br J Ophthalmol 2001;85:327-331
( March )
Utility values associated with blindness in an adult population
Melissa M Browna b, Gary C Browna c, Sanjay Sharmaa c d, Jonathan Kistlera c, Heidi Browna
a Center for
Evidence-Based Health Care Economics, Flourtown, PA, USA, b Cataract and Primary Eye Care Service,
Wills Eye Hospital, Jefferson Medical College, Philadelphia, PA, USA, c Retina Vascular Unit, Wills
Eye Hospital, Jefferson Medical College, Philadelphia, PA, USA, d Departments
of Ophthalmology, Epidemiology and the Cost-Effective Ocular Health
Policy Unit, Queens University, Kingston, Ontario, Canada
Correspondence to: Melissa M Brown, Center for
Evidence-Based Health Care Economics, Suite 210, 1107 Bethlehem Pike,
Flourtown, PA 19031, USA
Lissa1011{at}aol.com
Accepted for publication 9 October 2000
AIM To ascertain
utility values associated with varying degrees of legal blindness.
METHODSA cross
sectional study on three group of patients. There were: (1) 15 patients
with complete absence of vision (no light perception) in at least one
eye who were asked to assume a scenario of no light perception in the
second eye as well, (2) 17 patients with light perception to counting
fingers in the better seeing eye, and (3) 33 patients with
20/200-20/400 vision in the better seeing eye. Utility values were
measured using the time trade-off and standard gamble methods in each
of the three groups.
RESULTSThe mean time
trade-off utility value for the no light perception group with the
theoretical scenario of bilateral absence of light perception was 0.26 (95% CI, 0.19-0.33). The mean utility value for the light perception
to counting fingers group was 0.47 (95% CI, 0.33-0.61), and the mean
utility value for the 20/200-20/400 group was 0.65 (95% CI,
0.58-0.72). Thus, patients with no light perception in one eye, who
were presented with the same scenario in the second eye as well, were
willing to trade almost 3 out of every 4 years of remaining life in
return for perfect vision in each eye. Those with light perception to
counting fingers would trade approximately 1 of 2 remaining years and
those with 20/200-20/400 would trade approximately 1 of 3 remaining years.
CONCLUSIONSThere is a
wide range of utility values associated with legal blindness. The
utility value decreases dramatically with perceived total loss of
vision (absence of light perception in each eye), compared with
counting fingers to light perception vision, indicating that the
preservation of even small amounts of vision in patients with legal
blindness is critically important to their wellbeing and functioning in life.
© 2001 by British Journal of Ophthalmology
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