Measurements of vision function and quality of life in patients with cataracts in southern India. Report of instrument development

Arch Ophthalmol. 1997 Jun;115(6):767-74. doi: 10.1001/archopht.1997.01100150769013.


Objective: To develop and validate vision function (VF) and quality of life (QOL) instruments in patients with cataracts in the context of large volume surgery in a developing country.

Materials and methods: The instruments were developed using a consensus approach. One hundred patients who were undergoing cataract surgery at Aravind Eye Hospital, Madurai, India, were interviewed preoperatively and 3 and 12 months postoperatively. Standard clinical procedures were followed, including measurement of visual acuity. Between-interviewer reproducibility was measured by repeated administration of the preoperative questionnaire. Within-interviewer reproducibility was measured preoperatively in a separate study of 50 patients.

Results: Preoperative scores from the VF and QOL instruments were significantly associated with visual acuity (r = 0.4). Internal reliability (Cronbach alpha) was greater than .9. Both instruments showed large changes after surgery, with effect sizes of 3 or greater for most VF scales (range, 1.8-3.7) and 1 or greater for QOL scales (range, 1.0-2.2). Changes in visual acuity after surgery were correlated with changes in the VF (r = 0.44) and QOL (r = 0.41) scale scores. Between-interviewer reproducibility was acceptable (total VF scale, Spearman r = 0.7; total QOL scale; r = 0.74). The kappa values were lower for within-interviewer reproducibility.

Conclusions: The study provided strong evidence for the validity, reproducibility, and responsiveness of the instruments, and for the feasibility of using them in the setting of a large volume of cataract surgery in a developing country.

MeSH terms

  • Cataract / physiopathology*
  • Cataract Extraction
  • Female
  • Humans
  • India
  • Male
  • Middle Aged
  • Observer Variation
  • Postoperative Period
  • Quality of Life*
  • Reproducibility of Results
  • Vision, Ocular*
  • Visual Acuity