The impact of eyeglasses on vision-related quality of life in American Indian/Alaska Natives

Abstract

Purpose: To determine the change in vision-related quality-of-life scores after providing eyeglasses to American Indian/Alaska Natives with undercorrected refractive error.

Study design: Prospective, comparative (nonrandomized) interventional study.

Methods: We compared a group with undercorrected refractive error to a control group who did not need a change in eyeglasses. Undercorrected refractive error was defined as distance visual acuity 20/40 or worse in the better-seeing eye that could be improved by at least 2 lines in Snellen visual acuity. Intervention was the provision of new glasses to the undercorrected refractive error group members, based on results of manifest refraction. The main outcome measures were the differences in the 25-Item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) scores from baseline (Time 1) to the time after providing eyeglasses (Time 2).

Results: The NEI VFQ-25 median Composite score at Time 1 was significantly lower in those with undercorrected refractive error when compared to the control group (75 vs 92, P = .001). The median Composite score for the undercorrected refractive error group improved to 96 (P < .001) at Time 2 when compared to Time 1, while the control group remained stable at 93 (P = .417). The undercorrected refractive error group showed significantly greater improvement than the control group in 8 of 12 subscale scores and in the overall Composite score (all P values ≤ .05). A multivariate linear regression analysis, which controlled for differences in age, percent self-identified American Indian/Alaskan Native, and best-corrected visual acuity between the undercorrected refractive error and control group, showed eyeglasses to be significantly associated with improvement in NEI VFQ-25 composite score.

Conclusion: Visual impairment from undercorrected refractive error is common in American Indian/Alaskan Natives. Providing eyeglasses results in a large, significant increase in vision-related quality of life.

Figure 1

Amount of mean score change in vision-related quality of life between Time 1 and Time 2 as measured by the 25-Item National Eye Institute Visual Functioning Questionnaire, by Control and Under-corrected Refractive Error (UCRE) groups (*=p<0.05)