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Evaluating visual function in cataract

D B Elliott1

  • 1Centre for Sight Enhancement, School of Optometry, University of Waterloo, Ontario, Canada.

Optometry and Vision Science : Official Publication of the American Academy of Optometry
|November 1, 1993
PubMed
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Cataract visual impairment is mainly due to light scatter. While visual acuity (VA) is common, contrast sensitivity (CS) and glare tests better assess visual function, aiding cataract surgery decisions.

Area of Science:

  • Ophthalmology
  • Optometry
  • Vision Science

Background:

  • Cataract causes visual impairment primarily through increased intraocular light scatter.
  • Visual acuity (VA) measurements are standard but may not fully capture the impact of light scatter on vision.

Purpose of the Study:

  • To review research on evaluating visual function in cataract patients.
  • To assess the adequacy of current visual function tests and propose improvements.

Main Methods:

  • Review of recent research on visual function evaluation in cataract.
  • Discussion of visual acuity (VA), contrast sensitivity (CS) at different spatial frequencies, disability glare (DG) tests, and straylight measurement.
  • Consideration of binocular visual function.

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Main Results:

  • VA measurements alone are insufficient for assessing cataract-related visual impairment.
  • Measuring wide-angle light scatter, directly (straylight meter) or indirectly (low spatial frequency CS, DG tests), is necessary.
  • The relative usefulness of these tests and their integration into surgical decision-making are discussed.

Conclusions:

  • Current VA testing may underestimate visual impairment from cataract.
  • Incorporating straylight measurements and contrast sensitivity testing can provide a more comprehensive evaluation.
  • Considering binocular visual function is crucial for optimal patient outcomes.