Quality of life associated with visual loss: a time tradeoff utility analysis comparison with medical health states

Ophthalmology. 2003 Jun;110(6):1076-81. doi: 10.1016/S0161-6420(03)00254-9.


Purpose: To assess the visual utility values of patients with ocular disease and to compare these values with those of patients with systemic health states

Design: Cross-sectional utility value assessment.

Methods: Consecutive patients with ophthalmic diseases were interviewed in a one-on-one fashion using a standardized time tradeoff utility value assessment form. These values were compared with utility values for systemic health states present in the literature.

Intervention: None.

Main outcome measure: Time tradeoff utility value on a scale ranging from 1.0 (perfect visual health) to 0.0 (death). The ophthalmic patient groups were stratified into 4 visual groups dependent on the visual acuity in the better-seeing eye. The groups were as follows: group 1, 20/20 to 20/25; group 2, 20/30 to 20/50; group 3, 20/60 to 20/100; group 4, 20/200 to no light perception.

Results: A total of 500 subjects were enrolled in the study. The mean utility values for the visually stratified groups were: group 1, 0.88; group 2, 0.81; group 3, 0.72; group 4, 0.61. Comparable respective systemic health state utility values for each of the ophthalmic groups were: diabetes mellitus, status after kidney transplantation, moderate stroke, and moderately severe stroke.

Conclusions: Visual loss is associated with a substantial and measurable diminution in quality of life. This diminution in quality of life can be directly compared with that induced by systemic health states.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Female
  • Health Status Indicators
  • Health Status*
  • Humans
  • Male
  • Middle Aged
  • Quality of Life*
  • Quality-Adjusted Life Years*
  • Surveys and Questionnaires
  • Time Factors
  • Vision Disorders / psychology*
  • Visual Acuity*