Importance of Visual Acuity and Contrast Sensitivity in Patients With Glaucoma

OBJECTIVE: To determine which aspects of vision most influence the ability of patients with glaucoma to function. METHODS: A total of 192 patients with a full range of glaucomatous visual loss were selected from the Glaucoma Service of Wills Eye Institute. Patients were evaluated clinically with standard visual assessments: visual acuity, contrast sensitivity, visual field, stereopsis, the Disc Damage Likelihood Scale, and intraocular pressure. Patients were evaluated objectively using a comprehensive performance-based measure of visual function, the Assessment of Disability Related to Vision (ADREV), and subjectively with the 25-item National Eye Institute Visual Function Questionnaire. Statistical analyses, including Spearman correlation coefficients and regression analysis, were performed on the data. RESULTS: Performance on the ADREV was most strongly associated with binocular visual acuity (r = -0.79; P < .001) and binocular contrast sensitivity (r = 0.80; P < .001). Monocular and binocular visual field test results correlated well with the ability to perform the ADREV tasks, but there was a significantly weaker association (P < .05) compared with visual acuity and contrast sensitivity. CONCLUSION: The aspects of visual function that best predict the ability of a patient with glaucoma to perform activities of daily living are binocular visual acuity and contrast sensitivity.