VISION AND VISION-RELATED QUALITY OF LIFE IN PATIENTS WITH SENILE CATARACT

Abstract

Abstract Purpose: To assess the impact of senile cataract on the patient's visual, functional status and on quality of life. Methods: A cross-sectional, hospital based study was conducted in Makkah Eye Complex in Khartoum Alryad; in the period (October 2009-July 2010). Elderly patients (300); their age varied 60-95 years with senile cataract were asked to participate in the study. Participation was entirely voluntary. Information was collected by means of interviews, questionnaires, observation and clinical assessment. Further study was conducted with professionals for situation analysis: to investigate barriers and factors affecting surgical outcomes. The data were analyzed using SPAW Statistics-18 (2010) a modified version of SPSS. Results: In the presence of cataract the results shows significant declines in all of visual functions (>85% visually impaired). However, the value of IOP was not influenced by cataract presence. Statistically the visual acuity showed high positive correlations and high statistical significance before the surgery (Pearson chi-square p<0.00l) when compared with type of cataract, colour vision, refractive errors, central and peripheral visual field and (Pearson chi-square p<0.005) after surgery. The significant heterogeneous distribution suggests these tests are different but strongly correlated. Physical functions, emotional well-being, safety, and overall quality of life can be enhanced when visual functions are restored by cataract extraction. Improved visual functions as a result of cataract surgery included the following: Better optically corrected vision (71%) achieved satisfactory visual outcomes (Log MAR >0.48) with average distance (VA of 0.36-0.46 Log MAR). Seven percent in border line (Log MAR = 0.48). Increased ability to read and perform near work (average 0.22-0.42 Log MAR); improved ability to function in dim levels of light by increasing contrast sensitivity (1.35-1.65 Log units); improved peripheral (90%) and central visual field (>85%), and improved colour vision (90%). Improved physical functions included the following: Increased ability to perfonn activities of daily living (>93%), and increased mobility (>93%). However, financial conditions and opportunity to continue or resume an occupation remained imchanged (>75% not working). Improved psycho-social health and emotional well-being included the following benefits: Improved self-esteem (>99%), and independence (9%); increased ability to participate in social activities (>76%), and relief from fear of blindness (>1 8%). Surgical outcome criteria can vary for each patient, depending on the patient’s needs, lifestyle, and medical condition. In general, outcome criteria included the following: reduction of visual symptoms, improvement in visual functions, achievement of satisfactory visual outcomes and improvement in quality of life. Conclusions: The role of optometrist in geriatric care is to improve the patient's quality of life by facilitating independence and goal directed activity; to help patients with impaired vision to live useful lives, enjoy self-sufficiency, emotional independence and satisfactory social interactions; (>83%) of patients required optical correction after cataract extraction (70%) had achieved satisfactory visual outcomes. Eventually about 25% could benefit from low vision and rehabilitation services. Health education, treatment, support and opportunity are necessary for patients with senile cataract to remain independent and productive members of their communities. Ageing issues and cataract blindness treatments are challenges to us all: No single player can do it alone. ' Key words: Senile cataract, Visual impairment, Functional vision, Quality of life, Elderly rights, Supportive services, Geriatric optometry. '