Purpose Real-Life Vision Test (RLVT) is a newly developed performance-based measures of functional vision. This present study is designed to determine whether it could be a meaningful assessment for cataract surgery outcomes evaluation. Patients and methods Age-related cataract patients (56) who scheduled for bilateral cataract surgery and 44 age-matched controls were evaluated by four types of measurements: (1) demographic, medical, cognitive and depressive evaluation, and the reaction time testing; (2) clinical measures (visual acuity, contrast sensitivity, stereopsis, and color perception); (3) the 25-item National Eye Institute's Visual Functioning Questionnaire (NEI-VFQ); (4) the RLVT. Spearman's coefficients and multiple regression analysis were conducted to investigate the relationship among RLVT, clinical measures, and self-report assessment of visual function. Results The results of RLVT, clinical measures, and NEI-VFQ total scores were improved significantly after cataract surgery. There were no differences between control subjects and post-surgery patients with respect to NEI-VFQ-25 total scores, self-rating depression scale scores and three tasks of RLVT. Change of RLVT was significantly associated with the change of clinical measures in the cataract group. Multiple regression analysis demonstrated that change of distance, intermediate, and near visual acuity, and binocular contrast sensitivity were significant predictors of improvements of RLVT.Conclusions Cataract surgery could improve real-world visual ability effectively for cataract patients. Our study highlights the potential usefulness of RLVT as an adjunct to the current outcomes evaluation system for cataract surgery. The use of RLVT combined with clinical and self-survey methods may be the comprehensive strategy to manifest the impact of cataract surgery on patients' overall vision-related quality of life.

Purpose (1) To describe and validate a newly developed, timed performance-based measures of functional vision-the real-life vision test (RLVT). (2) To determine how RLVT relates to clinical measures and selfreport assessment of visual function and the complex interactions among visual impairment, psychosocial status, and demographic factors. Methods A total of 64 patients with age-related cataract and 45 age-matched controls were evaluated by four types of measurements: (1) demographic, medical, cognitive, and depressive evaluation and the reaction time (RT) testing; (2) clinical measures (visual acuity, contrast sensitivity, stereopsis, and the color perception); (3) the 25-item National Eye Institute's Visual Functioning Questionnaire; and (4) the RLVT. Spearman's coefficients, partial correlation, and multiple regression analysis were conducted to determine the relationship among RLVT, clinical measures, and selfreport assessment of visual function while controlling for confounders. Results Control subjects performed RLVT significantly better than the cataract patients. RLVT correlated well with both clinical and self-report assessments of visual function. All subscales of RLVT remained highly associated with most of the clinical measures, even after adjusting for age, years of education, depression, cognitive status, and the RT. Distance, intermediate and near visual acuity, and binocular contrast sensitivity were significant predictors of the RLVT performances. Conclusions Given the strong relationship among RLVT, clinical measures, and the self-report assessments, our results highlight the potential usefulness of RLVT for assessing the functional vision of cataract patients. RLVT may provide information not obtainable from clinical measures or surveys and therefore it is essential to be incorporated into future ophthalmological practice.

PurposeTo assess the vision-related quality of life and self-reported driving performance of patients with dry eye disease (DED).Patients and methodsThe study was performed in the eye centre of Peking University Third Hospital, China. In total, 87 dry eye patients and 42 controls were enroled, including 49 patients without any treatment (group A), 38 patients treated with artificial tears (group B) and 42 controls without DED (group C). The participants had no eye disease other than DED. Scores of a vision-related quality-of-life questionnaire (Ocular Surface Disease Index (OSDI)), a daily life-related visual function questionnaire and a questionnaire about performance during driving were collected. Data were compared among the groups and analysed.ResultsSignificant differences in all clinical characteristics and OSDI scores were found between DED patients and normal controls (P<0.05). While subjects in group A felt more uncomfortable than those in group B, the functional limitations related to dry eye were significant in all DED patients, especially for daily work and using a computer. DED was correlated with unsafe driving habits and performance, which may increase the risk of dangerous driving (P<0.01). For patients with DED, the rate of accidents and near-accidents was 10.33%, and the rate of missed targets totalled 32.17%.ConclusionsDED can lead to many inconveniences in daily life, including driving. The frequencies of unsafe driving habits and performance were increased in patients with DED.