Abstract
Purpose To measure the effect of cataract type, severity and location on presenting, and best-corrected visual acuity, contrast sensitivity, and glare disability.
Methods In all, 3654 (82.4% participation rate) eligible noninstitutionalised residents aged 49 years or older, living in two postcode areas of the Blue Mountains, Australia, received detailed eye examinations including visual acuity, contrast sensitivity, and glare disability testing. Data from right eyes were analysed using multiple regression modelling.
Results The effect of age on visual acuity and contrast sensitivity only became evident in persons aged at least 60 years. Cataract severity was inversely related to visual acuity and contrast sensitivity. Late posterior subcapsular cataract caused the greatest reduction in visual acuity. Early grade cataract caused significant reduction in contrast sensitivity at intermediate and high spatial frequencies, but late grade cataract reduced contrast sensitivity across all spatial frequencies. There was insufficient study power to detect consistent significant effect of cataract on glare disability tests or cortical cataract location on visual function.
Conclusions Age at least 60 years, cataract type, and cataract severity were principal determinants of visual acuity and contrast sensitivity in this study. Axial and superotemporally located cortical cataract had the greatest effect on visual function tests.
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References
Mitchell P, Cumming RG, Attebo K, Panchapakesan J . Prevalence of cataract in Australia: the Blue Mountains eye study. Ophthalmology 1997; 104: 581–588.
Elliott DB, Bullimore MA, Patla AE, Whitaker D . Effect of a cataract simulation on clinical and real world vision. Br JOphthalmol 1996; 80: 799–804.
Elliott DB, Hurst MA, Weatherill J . Comparing clinical tests of visual loss in cataract patients using a quantification of forward light scatter. Eye 1991; 5: 601–606.
White paper on cataract surgery. American Academy of Ophthalmology and American Society of Cataract and Refractive Surgery. Ophthalmology 1996; 103: 1152–1156.
Adamsons I, Rubin GS, Vitale S, Taylor HR, Stark WJ . The effect of early cataracts on glare and contrast sensitivity. A pilot study Arch Ophthalmol 1992; 110: 1081–1086.
Obstbaum SA . Indications and timing of cataract surgery. J Cataract Refract Surg 1995; 21: 483.
Steinberg EP, Bass EB, Luthra R, Schein OD, Sharkey P, Javitt J et al. Variation in ophthalmic testing before cataract surgery. Results of a national survey of ophthalmologists. Arch Ophthalmol 1994; 112: 896–902.
Lasa MS, Podgor MJ, Datiles MB, Caruso RC, Magno BV . Glare sensitivity in early cataracts. Br J Ophthalmol 1993; 77: 489–491.
Hess R, Woo G . Vision through cataracts. Invest Ophthalmol Vis Sci 1978; 17: 428–435.
Paulsson LE, Sjostrand J . Contrast sensitivity in the presence of a glare light. Theoretical concepts and preliminary clinical studies. Invest Ophthalmol Vis Sci 1980; 19: 401–406.
Skalka HW . Arden grating test in evaluating "early" posterior subcapsular cataracts. South Med J 1981; 74: 1368–1370.
Abrahamsson M, Sjostrand J . Impairment of contrast sensitivity function (CSF) as a measure of disability glare. Invest Ophthalmol Vis Sci 1986; 27: 1131–1136.
Hard AL, Abrahamsson M, Sjostrand J . A new glare test based on low contrast letters—evaluation in cataract patients. Acta Ophthalmol 1990; 68: 145–150.
Lasa MS, Datiles MB3, Podgor MJ, Magno BV . Contrast and glare sensitivity. Association with the type and severity of the cataract. Ophthalmology 1992; 99: 1045–1049.
Rochtchina E, Mitchell P, Coroneo M, Wang JJ, Cumming RG . Lower nasal distribution of cortical cataract: the Blue Mountains Eye Study. Clin Exp Ophthalmol 2001; 29: 111–115.
Klein BE, Klein R, Linton KL . Prevalence of age-related lens opacities in a population. The Beaver Dam Eye Study. Ophthalmology 1992; 99: 546–552.
Schein OD, West S, Munoz B, Vitale S, Maguire M, Taylor HR et al. Cortical lenticular opacification: distribution and location in a longitudinal study. Invest Ophthalmol Vis Sci 1994; 35: 363–366.
Brown NA . The morphology of cataract and visual performance. Eye 1993; 7: 63–67.
Drews-Bankiewicz MA, Caruso RC, Datiles MB, Kaiser-Kupfer MI . Contrast sensitivity in patients with nuclear cataracts. Arch Ophthalmol 1992; 110: 953–959.
Elliott DB, Gilchrist J, Whitaker D . Contrast sensitivity and glare sensitivity changes with three types of cataract morphology: are these techniques necessary in a clinical evaluation of cataract? Ophthal Physiol Opt 1989; 9: 25–30.
Ariyasu RG, Lee PP, Linton KP, LaBree LD, Azen SP, Siu AL . Sensitivity, specificity, and predictive values of screening tests for eye conditions in a clinic-based population. Ophthalmology 1996; 103: 1751–1760.
Adamsons IA, Vitale S, Stark WJ, Rubin GS . The association of postoperative subjective visual function with acuity, glare, and contrast sensitivity in patients with early cataract. Arch Ophthalmol 1996; 114: 529–536.
Ivers RQ, Optom B, Macaskill P, Cumming RG, Mitchell P . Sensitivity and specificity of tests to detect eye disease in an older population. Ophthalmology 2001; 108: 968–975.
Elliott DB, Situ P . Visual acuity versus letter contrast sensitivity in early cataract. Vision Res 1998; 38: 2047–2052.
Miyajima H, Katsumi O, Wang GJ . Contrast visual acuities in cataract patients. I. Comparison with normal subjects. Acta Ophthalmol Copenh 1992; 70: 44–52.
Rouhiainen P, Rouhiainen H, Salonen JT . Contrast sensitivity in different types of early lens opacities. Acta Ophthalmol Scand 1996; 74: 379–383.
Panchapakesan J, Cumming RG, Mitchell P . Reproducibility of the Wisconsin cataract grading system in the Blue Mountains Eye Study. Ophthal Epidemiol 1997; 4: 119–126.
Johnson M, Choy D . On the definition of age-related norms for visual function testing. Appl Opt 1987; 26: 1449–1454.
Lasa MS, Datiles MB3, Podgor MJ, Magno BV . Contrast and glare sensitivity. Association with the type and severity of the cataract. Ophthalmology 1992; 99: 1045–1049.
Ivers RQ, Mitchell P, Cumming RG . Visual function tests, eye disease and symptoms of visual disability: a population-based assessment. Clin Exp Ophthalmol 2000; 28: 41–47.
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Chua, B., Mitchell, P. & Cumming, R. Effects of cataract type and location on visual function: The Blue Mountains Eye Study. Eye 18, 765–772 (2004). https://doi.org/10.1038/sj.eye.6701366
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DOI: https://doi.org/10.1038/sj.eye.6701366
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