The Impact of Visual and Nonvisual Factors on Quality of Life and Adaptation in Adults with Visual Impairment

PURPOSE. Quality of life (QoL) questionnaires have been suggested as the most appropriate way to measure the effectiveness of low vision rehabilitation. This study investigated the relative contribution of visual and psychosocial factors to different aspects of QoL in people with low vision. METHODS. A total of 448 consecutive patients between the ages of 18 and 96 years, with best-corrected binocular visual acuity <= 6/18 and attending a low vision clinic, were recruited. Telephone delivery of previously validated questionnaires was used. The Low Vision Quality of Life (LVQOL), the Adaptation to Age-Related Vision Loss (AVL)-12, and the Keele Participation Restriction Questionnaire (KAP) questionnaires were considered as outcome measures for functional vision, adaptation to vision loss, and participation restriction, respectively. Personality (BFI-10), religious beliefs (SBI-15), social support (MOS), the mental and physical components of general health (the MCS and PCS of SF-12), well-being (WHO-5), use of magnifiers (MLVQ), understanding of their eye condition and satisfaction with the eye clinic (MLVQ), level of education, and financial status were all considered as predictive of QoL. RESULTS. Regression analysis found the PCS and MCS from SF-12 to be major predictors of LVQOL, AVL-12, and KAP scores. Although distance visual acuity and contrast sensitivity were predictors of LVQOL scores, use of magnifiers did not contribute to any of the QoL measures. CONCLUSIONS. Nonvisual factors, such as physical and mental health, were found to be stronger predictors of QoL in people with low vision than visual factors such as contrast sensitivity and visual acuity, or the use of magnifiers. Researchers need to be aware when measuring QoL in a population with low vision that even vision-related QoL is strongly influenced by nonvisual variables. (Invest Ophthalmol Vis Sci. 2012;53:4234-4241) DOI:10.1167/iovs.12-9580