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Visual functioning and quality of life outcomes among cataract operated and unoperated blind populations in Nepal
  1. G P Pokharela,
  2. S Selvarajb,
  3. Leon B Ellweinc
  1. aFoundation Eye Care Himalaya, Kathmandu, Nepal, bAravind Eye Hospital, Madurai, India, cNational Eye Institute, Bethesda, Maryland, USA
  1. Leon B Ellwein, PhD, National Eye Institute, 31 Center Drive, MSC 2510, Bldg 31, Rm 6A-04, Bethesda, MD 20892–2510, USA.


BACKGROUND Visual acuity and vision related quality of life outcomes in cataract surgery were evaluated in a population based survey in two geographic zones in Nepal.

METHODS Case finding was based on random sampling using a stratified cluster design with door to door enumeration of people aged ⩾45 years followed by eye examinations at village sites. All aphakics/pseudophakics, those with visual acuity less than 6/60 in either eye, and a sample of those with normal visual acuity were administered visual functioning (VF) and quality of life (QOL) questionnaires.

RESULTS 15% of the 159 cataract operated cases had presenting visual acuity ⩾6/18 in both eyes, 38% with best corrected visual acuity. 21% were still blind with presenting visual acuity <6/60 in both eyes, 7% with best correction. On a 0–100 scale, mean VF and QOL scores were 87.2 and 93.9 respectively in normally sighted unoperated individuals, dropping to 15.6 and 29.5 for those severely blind (<3/60). Among the cataract operated, mean VF and QOL scores were 47.5 and 55.4, respectively. VF and QOL scores correlated with vision status at statistically significant levels (p <0.0001)

CONCLUSION Cataract surgery outcomes, whether measured by traditional visual acuity or by patient reported VF/QOL, are at levels many would consider unacceptably low. It is apparent that in the quest to reduce cataract blindness much more attention must be given to improving surgery outcomes.

  • cataract surgery
  • visual acuity
  • visual functioning
  • quality of life

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