The Impact of Diabetic Retinopathy on Participation in Daily Living

OBJECTIVE: To determine the restriction of participation in daily activities of people with diabetic retinopathy using the Impact of Vision Impairment questionnaire. METHODS: Individuals with diabetic retinopathy and a visual acuity (VA) worse than 20/40 or 6/12 in the better eye were eligible. Participants answered demographic questions and had VA information abstracted from medical records. If VA information was unavailable, it was assessed by an orthoptist. MAIN OUTCOME MEASURES: All participants completed the Impact of Vision Impairment questionnaire, which was either self-administered or interviewer administered. The physical and mental health components were assessed using the Medical Outcomes Study 12-Item Short Form (SF-12) questionnaire. RESULTS: Forty-five participants (mean age, 67.5 years) were recruited, with almost 70% (30/45) recording a VA worse than 20/60 or 6/18 in the better eye. The median duration of vision loss was 2.0 years. The highest restriction was reported for the Leisure and Work, Mobility, and Consumer and Social Interaction domains (mean, 3.0, 2.8, and 2.8, respectively), compared with the Emotional Reaction to Visual Loss and Household and Personal Care domains (mean, 2.3 and 2.1, respectively) (P<.005). The activities with the greatest restriction of participation were reading print, mobility, work, and leisure. A poorer VA in the better eye correlated independently with increased restriction of participation, as measured by the Impact of Vision Impairment questionnaire scores (partial correlations, 0.29-0.41; P< or =.03). CONCLUSION: Low-vision rehabilitation services aiming to improve outdoor mobility, print reading, participation in leisure activities, and psychological health may be an effective strategy to help people with diabetic retinopathy increase their participation in daily activities.