[Evaluation of the quality of life in ophthalmology]

THE IMPORTANCE OF VISUAL FUNCTION IN THE ASSESSMENT OF QUALITY OF LIFE: The notion of visual function is related to visual acuity but also to many other parameters such as the visual field, perception of colour, contrasts, and the resistance to blinding. These factors are difficult to measure during routine ophthalmic examination but can be assessed during questionnaires on quality of life. MARKERS OF QUALITY OF LIFE IN OPHTHALMOLOGY: Various quality of life questionnaires have been developed in ophthalmology because the non-specific generic instruments appear inadequate. The SF 36 and SF 20 scales, which are generic instruments widely used in many fields, do not adequately explore the problems related to vision. The first efficient instrument is the VF 14, which is a questionnaire specific to ophthalmic diseases, developed by C. Mangione in 1992. This self-administered questionnaire permits calculation of a 0 to 100 score exploring 5 dimensions (long-sight acuity, near-sight acuity, unclear sight, and driving during the day and at night) during 14 activities with 18 questions. It was translated and adapted into French by Gresset in 1997. Today it is the most commonly used questionnaire in ophthalmology, particularly in the assessment of efficacy and impact in surgery. Along the other specific questionnaires developed, there is the NEI-VQF which was created in 1995 to assess vision and the impact of visual problems on the quality of life of patients, independently of an ophthalmic pathology. Many studies have been conducted on various diseases that affect vision, such as diabetes or hypertension. THE LIMITS OF EXISTING INSTRUMENTS: The specific scales appear far more sensitive and specific than generic scales with regard to ophthalmic problems, but they provide less information on the general status of the patient, except for the NEI-VQF. They are limited in some parameters and do not, unfortunately, take into account the patient's age. No specific scale has been developed for children or adolescents, although the impact of vision on daily life is fundamental. The complexity of vision means that the elaboration of an ideal instrument is difficult. However, in the meantime, it is essential that the practitioners continue to use and to test the instruments available in order to improve with regard to pathologies, or in particular sub-groups of the population.