Seeing Is Believing: Vision‐Related Quality of Life Among Hospitalized Patients

Background:

Impaired vision is a risk factor for poor health outcomes, such as falls and delirium, during hospitalization. Additionally, hospitalized patients with poor vision may be unable to read critical documents such as consent forms. Vision has large implications for quality of life, including the ability to interact with others and accomplish daily tasks. Our previous work has shown that nearly one‐third of hospitalized patients fail an inpatient vision screening. As such, the hospital may represent a missed opportunity to address poor vision and its quality of life (QOL) implications. Therefore, our study set out to examine the prevalence and effect of poor vision on vision‐related QOL among hospitalized patients.

Methods:

Hospitalized adult general medicine inpatients at the University of Chicago were enrolled in an ongoing study of resource‐allocation and quality‐of‐care. Eligible patients (English speaking, cognitively intact) were given a vision screening (Snellen Eye Chart); those who had 20/50 or better visual acuity in at least one eye were classified as having sufficient vision. Vision‐related QOL was measured using the validated National Eye Institute 25‐item Visual Functioning Questionnaire (VFQ, scale of 0‐100) which covers vision health (near and far sight), social functioning (e.g., visiting people), and mental health (composite of being embarrassed, frustrated, having less control and worrying about vision problems), among other domains.

Results:

Of the 405 participants who completed the vision screening, the majority were female (57%) and African American (77%) with a mean age of 54 years. Half (49%) had ≤ a high school degree, and about one‐quarter (n=92, 23%) had insufficient vision. On the single item health screen, participants with poor vision were more likely to say they had £good health than participants with sufficient vision (86/92, 93% vs. 259/313, 83% p=0.011). Those with poor vision were also more likely to report increased dependency on others (p<0.001), trouble with activities requiring near‐vision (p<0.001) and trouble with activities requiring far‐vision (p=0.001), decreased social functioning (p<0.001) and decreased mental health (p<0.001). Participants under 65 had lower vision‐related mental health than their older counterparts (81.9 vs. 86.6, p=0.045).

Conclusions:

Given the high prevalence of poor vision and its relationship to diminished vision‐related QOL among inpatients, the hospital may represent an important setting to identify patients with poor vision. Future work to test interventions to improve vision and related quality‐of‐life for inpatients are needed, especially for younger patients who may have the most to benefit.