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Open Access Research article

Is the NEI-VFQ-25 a useful tool in identifying visual impairment in an elderly population?

Christopher G Owen1*, Alicja R Rudnicka1, Liam Smeeth2, Jennifer R Evans2, Richard PL Wormald3 and Astrid E Fletcher2

Author Affiliations

1 Division of Community Health Sciences, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK

2 Centre for Ageing and Public Health, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK

3 Moorfields Eye Hospital, City Road, London, EC1V 2PD, UK

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BMC Ophthalmology 2006, 6:24  doi:10.1186/1471-2415-6-24

Published: 9 June 2006

Abstract

Background

The use of self-report questionnaires to substitute for visual acuity measurement has been limited. We examined the association between visual impairment and self reported visual function in a population sample of older people in the UK.

Methods

Cross sectional study of people aged more than 75 years who initially participated in a trial of health screening. The association between 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ) scores and visual impairment (defined as an acuity of less than 6/18 in the better eye) was examined using logistic regression.

Results

Visual acuity and NEI-VFQ scores were obtained from 1807 participants (aged 77 to 101 years, 36% male), from 20 general practices throughout the UK. After adjustment for age, gender, practice and NEI-VFQ sub-scale scores, those complaining of poor vision in general were 4.77 times (95% CI 3.03 to 7.53) more likely to be visually impaired compared to those who did not report difficulty. Self-reported limitations with social functioning and dependency on others due to poor vision were also associated with visual impairment (odds ratios, 2.52, 95% CI 1.55 to 4.11; 1.73, 95% CI 1.05 to 2.86 respectively). Those reporting difficulties with near vision and colour vision were more likely to be visually impaired (odds ratios, 2.32, 95% CI 1.30 to 4.15; 2.25, 95% CI 1.35 to 3.73 respectively). Other NEI-VFQ sub-scale scores were unrelated to measures of acuity. Similar but weaker odds ratios were found with reduced visual acuity (defined as less than 6/12 in the better eye). Although differences in NEI-VFQ scores were small, scores were strongly associated with visual acuity, binocular status, and difference in acuity between eyes.

Conclusion

NEI-VFQ questions regarding the quality of general vision, social functioning, visual dependency, near vision and colour vision are strongly and independently associated with an objective measure of visual impairment in an elderly population.