Visual field damage can be a telltale marker for the diagnosis and management of glaucoma, but according to a recent study it may not be the main visual prediction measurement for functional ability in glaucoma patients.

In a paper presented yesterday at the ARVO conference in Honolulu, Hawaii, a research team from Wilmer Eye Institute enrolled 152 glaucoma patients and analyzed the functional outcomes related to their quality of life. These included fear of falling, driving cessation, maximum reading speed and balance. Patients’ vision was evaluated using seven measures: average sensitivity across integrated visual field (IVF), visual acuity (VA), contrast sensitivity (CS), area-under-the-log contrast sensitivity function (AULCSF), color vision, distance steroacuity and visual acuity in noise (VIN).

The investigators found different dominant visual measures for each of the participant’s quality of life measures. CS was the dominant factor for glaucoma-related quality of life, while visual acuity was the dominant visual measure linked to fear of falling, driving cessation and reading speed. AULCSF was the dominant visual measure for balance, and IVF ranked second to fifth as the most dominant predictor for the functional outcomes.

“Visual field damage is not the most highly predictive of functional ability,” says Joseph P. Shovlin, OD, of Scranton, PA. “A battery of functional tests may be best suited to assessing functional impairment in glaucoma patients. Not too surprising, contrast sensitivity was the most dominant visual measure with regard to glaucoma-related quality of life. VA was the dominant measure for a number of functional outcomes.”

Ramulu P, Mihailovic A. Visual features most relevant to function impairment in glaucoma. ARVO 2018. Abstract 1943.