Functional impact of lens opacities: See project

Purpose. To determine the impact of the type and severity of lens opacities on self-report of functional status in an older population. Methods. In the Salisbury Eye Evaluation Project, 2520 persons have been recruited from a population based sample of Whites and African Americans ages 65 to 84. Lens photographs were taken, and the photographs graded for the presence and severity of nuclear, cortical, and mixed opacities using the Wilmer Grading System. The Activities of Daily Vision (ADV) questionnaire, with modifications for pre-clinical disability was administered. The scores on the ADV, and on the sub-scales, were evaluated for the association with age, sex, race, and presence of pure nuclear, pure cortical, or mixed opacities in the eye with the least amount of opacification. Results. The overall ADV score was 91 in those with no lens opacity, 86 in those with pure cortical, 85 in those with pure nuclear, and 81 in those with mixed opacities. ADV scores declined with age in all three opacity groups, as well as in those with no opacities. The lowest age-specific scores (representing more functional impairment) occurred in the mixed opacity group. Lower scores on tasks in each of the sub-scales was associated with the presence of mixed opacities. Cortical opacities were not significantly associated with scores for night or day driving, near vision, or glare tasks, but were associated with lower scores for far vision tasks. Nuclear opacities were associated with all the sub-scale tasks except for the day driving sub-scale. Conclusions. Lens opacities have an impact on vision tasks which varies not only by severity, but by type of opacity.