Visual Field Staging Systems in Glaucoma and the Activities of Daily Living

Kulkarni and associates present an important study by correlating different scoring systems of visual field defects in glaucoma patients with their vision-related functional impairment. Not only did they implement the most commonly used questionnaire instrument in ophthalmology, the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25), functional impairment also was assessed by performance-based measurements (the Assessment of Disability Related to Vision Test [ADREV]). This is a very important and relatively new approach to obtain an idea of the real-life functional impairment of the glaucoma patient. The authors report that the simple visual field scoring with the mean defect (MD) performs very well with the functional impairment in terms of NEI VFQ-25 and ADREV scores. With the data presented in Tables 2 and 3, MD is correlated moderately with the NEI VFQ-25 composite score (r = 0.42 and r = 0.39 for better and worse eye, respectively) and the ADREV score (r = 0.47 and r = 0.40 for better and worse eye, respectively). Looking at these data, it is hard to understand the authors statement, that “correlations with the worse eye were far weaker” than for the better eye. With regard to the MD data above, this equals a difference in the correlation coefficient of 0.03 for the NEI VFQ-25 and 0.07 for the ADREV.