Use of subjective and objective criteria to categorise visual disability.
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Date
2014-04
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Abstract
Context: Visual disability is categorised using objective criteria. Subjective measures are not
considered. Aim: To use subjective criteria along with objective ones to categorise visual disability.
Settings and Design: Ophthalmology out‑patient department; teaching hospital; observational study.
Material and Methods: Consecutive persons aged >25 years, with vision <20/20 (in one or both eyes) due
to chronic conditions, like cataract and refractive errors, were categorized into 11 groups of increasing
disability; group‑zero: normal range of vision, to group‑X: no perception of light, bilaterally. Snellen’s vision;
binocular contrast sensitivity (Pelli‑Robson chart); automated binocular visual field (Humphrey; Esterman
test); and vision‑related quality of life (Indian Visual Function Questionnaire‑33; IND‑VFQ33) were
recorded. Statistical Analysis: SPSS version‑17; Kruskal‑wallis test was used to compare contrast sensitivity
and visual fields across groups, and Mann‑Whitney U test for pair‑wise comparison (Bonferroni adjustment;
P < 0.01). One‑way ANOVA compared quality of life data across groups; for pairwise significance, Dunnett
T3 test was applied. Results: In 226 patients, contrast sensitivity and visual fields were comparable for
differing disability grades except when disability was severe (P < 0.001), or moderately severe (P < 0.01).
Individual scales of IND‑VFQ33 were also mostly comparable; however, global scores showed a distinct
pattern, being different for some disability grades but comparable for groups III (78.51 ± 6.86) and
IV (82.64 ± 5.80), and groups IV and V (77.23 ± 3.22); these were merged to generate group 345; similarly,
global scores were comparable for adjacent groups V and VI (72.53 ± 6.77), VI and VII (74.46 ± 4.32), and VII
and VIII (69.12 ± 5.97); these were merged to generate group 5678; thereafter, contrast sensitivity and global
and individual IND‑VFQ33 scores could differentiate between different grades of disability in the five new
groups. Conclusions: Subjective criteria made it possible to objectively reclassify visual disability. Visual
disability grades could be redefined to accommodate all from zero‑100%.
Description
Keywords
Blindness, disability evaluation, quality of life, visual acuity
Citation
Kajla Garima, Rohatgi Jolly, Dhaliwal Upreet. Use of subjective and objective criteria to categorise visual disability. Indian Journal of Ophthalmology. 2014 Apr ; 62 (4): 400-406.