Importance of visual acuity and contrast sensitivity in patients with glaucoma.

OBJECTIVE To determine which aspects of vision most influence the ability of patients with glaucoma to function. METHODS A total of 192 patients with a full range of glaucomatous visual loss were selected from the Glaucoma Service of Wills Eye Institute. Patients were evaluated clinically with standard visual assessments: visual acuity, contrast sensitivity, visual field, stereopsis, the Disc Damage Likelihood Scale, and intraocular pressure. Patients were evaluated objectively using a comprehensive performance-based measure of visual function, the Assessment of Disability Related to Vision (ADREV), and subjectively with the 25-item National Eye Institute Visual Function Questionnaire. Statistical analyses, including Spearman correlation coefficients and regression analysis, were performed on the data. RESULTS Performance on the ADREV was most strongly associated with binocular visual acuity (r = -0.79; P < .001) and binocular contrast sensitivity (r = 0.80; P < .001). Monocular and binocular visual field test results correlated well with the ability to perform the ADREV tasks, but there was a significantly weaker association (P < .05) compared with visual acuity and contrast sensitivity. CONCLUSION The aspects of visual function that best predict the ability of a patient with glaucoma to perform activities of daily living are binocular visual acuity and contrast sensitivity.