Self-reported driving difficulty in patients with bilateral cataract

Purpose: The presence of cataract causes reduction in visual acuity (VA) and contrast sensitivity (CS) and thus can affect individual's daily activities. The aim of this study was to investigate self-reported driving difficulty in patients with bilateral cataract.MethodsA total of 99 participants aged 50 and above, with bilateral cataract, who possessed a valid driving license and drove regularly were chosen for this cross-sectional study that looked into their visual functions (VA and CS) and driving difficulty using the self-reported Driving Difficulty Questionnaire.ResultsThe mean age of the participants was 65.04±7.22 years old. Results showed that the mean composite driving difficulty score was 83.18±11.74 and most of the participants were having difficulty for driving in the rain (73.7%) and at night (85.9%). Furthermore, the study found that there was a significant correlation between driving difficulty score and CS (rs = 0.40, p = 0.03). However, there was no significant correlation between driving difficulty score and VA (rs = -0.14, p = 0.17). A linear regression was calculated to predict driving difficulty score based on binocular CS and a significant regression equation was found (F (1,28) = 8.115, p = 0.008) with R² of 0.225. Drivers with bilateral cataract will most likely experience some forms of difficulty, especially when driving under low contrast conditions.ConclusionThe findings of this study demand that a comprehensive eye examination should be made compulsory for older adult drivers when issuing or renewing their driving license for the safety of all road users. (AU)

Towards a Connected Mobile Cataract Screening System: A Future Approach.

Advances in computing and AI technology have promoted the development of connected health systems, indirectly influencing approaches to cataract treatment. In addition, thanks to the development of methods for cataract detection and grading using different imaging modalities, ophthalmologists can make diagnoses with significant objectivity. This paper aims to review the development and limitations of published methods for cataract detection and grading using different imaging modalities. Over the years, the proposed methods have shown significant improvement and reasonable effort towards automated cataract detection and grading systems that utilise various imaging modalities, such as optical coherence tomography (OCT), fundus, and slit-lamp images. However, more robust and fully automated cataract detection and grading systems are still needed. In addition, imaging modalities such as fundus, slit-lamps, and OCT images require medical equipment that is expensive and not portable. Therefore, the use of digital images from a smartphone as the future of cataract screening tools could be a practical and helpful solution for ophthalmologists, especially in rural areas with limited healthcare facilities.

Self-reported driving difficulty in patients with bilateral cataract.

PURPOSE: The presence of cataract causes reduction in visual acuity (VA) and contrast sensitivity (CS) and thus can affect individual's daily activities. The aim of this study was to investigate self-reported driving difficulty in patients with bilateral cataract. METHODS: A total of 99 participants aged 50 and above, with bilateral cataract, who possessed a valid driving license and drove regularly were chosen for this cross-sectional study that looked into their visual functions (VA and CS) and driving difficulty using the self-reported Driving Difficulty Questionnaire. RESULTS: The mean age of the participants was 65.04±7.22 years old. Results showed that the mean composite driving difficulty score was 83.18±11.74 and most of the participants were having difficulty for driving in the rain (73.7%) and at night (85.9%). Furthermore, the study found that there was a significant correlation between driving difficulty score and CS (rs = 0.40, p = 0.03). However, there was no significant correlation between driving difficulty score and VA (rs = -0.14, p = 0.17). A linear regression was calculated to predict driving difficulty score based on binocular CS and a significant regression equation was found (F (1,28) = 8.115, p = 0.008) with R² of 0.225. Drivers with bilateral cataract will most likely experience some forms of difficulty, especially when driving under low contrast conditions. CONCLUSION: The findings of this study demand that a comprehensive eye examination should be made compulsory for older adult drivers when issuing or renewing their driving license for the safety of all road users.

The Quality of Life Impact Refractive Correction (QIRC) questionnaire: validation of the Malay-translated version of the QIRC using Rasch analysis.

BACKGROUND: The Quality of Life Impact Refractive Correction (QIRC) questionnaire is a Rasch-validated instrument to assess the quality of life of ametropes with refractive correction. The original QIRC was validated in the United Kingdom. This study aimed to validate the Malay version of the QIRC among refractive correction wearers in Malaysia using Rasch analysis. METHODS: The original 20-item QIRC was forward-backward translated into Malay in preparation for the Pilot Malay QIRC. The pilot version was pre-tested on 105 spectacle/contact lens-corrected myopes, and the results were reviewed and cross-culturally adapted to produce the Final Malay QIRC. The final version was self-administered to a new sample of 304 participants. A Rasch analysis was conducted to evaluate the items and response categories of the Pilot and the Final Malay QIRC. Test-retest reliability was also analysed on the Final Malay QIRC. RESULTS: Based on the pre-test findings, Rasch analysis revealed a multidimensional scale (functional scale [Items 1 to 13] and emotional scale [Items 14 to 20], which were separated in subsequent analysis), unordered response categories for the functional scale (Category 3 was collapsed into Category 2), one misfit item (Item 3 was removed) and six items required modification (Items 4, 6 to 9, and 12 were reworded and cross-culturally adapted). In the Final Malay QIRC, both the functional and emotional scales had ordered response categories, good person reliability (functional, 0.80; emotional, 0.81) and separation index (functional, 2.01; emotional, 2.06), well-targeted items (targeting precision: functional, 0.28 logits; emotional, 0.08 logits), and satisfactory fit statistics (infit and outfit mean square were less than 1.50 for all items). A noticeable differential item functioning (DIF) between genders was found in Item 18 (DIF contrast, 0.40 logits; p = 0.04). Test-retest reliability analysis demonstrated a high intraclass correlation coefficient (0.94) and Cronbach's alpha (0.97) with a coefficient of repeatability of ±8.14 units. CONCLUSIONS: The Malay-translated version of the QIRC has good psychometric characteristics for assessing the quality of life of refractive correction wearers in Malaysia. This translated and cross-culturally adapted Malay QIRC is a valid and reliable instrument that can be used in routine clinical practice.