Development and Validation of a Lighting Facility for the Objective Assessment of the Visual Performance of Presbyopic Patients in a Series of Activities of Daily Living

Abstract

Introduction The primary objective of this study is to develop and validate an experimental lighting facility that allows the evaluation of near and intermediate vision in different user-defined illuminance levels. Methods This is a prospective, randomized, controlled study. Normophakic patients populated three validation groups (VGs) according to their binocular uncorrected near visual acuity (UNVA): a) VG1, 0.0-0.1 logMAR; b) VG2, 0.4 logMAR; and c) VG3, 0.7 logMAR. All participants addressed 10 near and intermediate activities of daily life (ADLs) in the three following lighting settings: 1) 25 foot candles (fc)/3000 kelvins (K), 2) 50 fc/4000 K, and 3) 75 fc/6000 K. Results Thirty patients in each group performed all ADLs in the three lighting settings. VG1 demonstrated the best ADL scores in all ADLs and lighting settings, followed by the VG2. VG3 presented the worst scores. ADLs using printed material showed significant differences among the three lighting settings for all study groups, while ADLs using screens or needing manual dexterity demonstrated no significant differences except for the Screwdriver Test (ST) in VG1. All ADL scores demonstrated a high correlation with UNVA in all lighting settings (p < 0.001). Conclusion This is the first study that validates a lighting facility for comparative studies in patients with different near vision capacities performing a series of ADLs.

Impact of Light Conditions on Visual Performance following Premium Pseudophakic Presbyopia Corrections

“…The present study was conducted in a special experimental facility constructed at the University Hospital of Alexandroupolis, as described in the corresponding validation study [ 22 ]. An advanced light diffusion system consisting of four linear LED luminaires was installed in a hospital room with a dimension of 6.87 m × 2.9 m × 3 m (depth × width × height) and flat white surface walls (reflectance: 70%).…”

“…The four LED luminaires were mounted on the ceiling. The amount of the provided luminous flux and the exact luminaire positioning were defined using the RELUX light simulation tool (version 2021.1.1.0) (Relux Informatik AG, Münchenstein, Switzerland) before installation ( Figure 1 ) [ 22 ]. The confirmation of illuminance and on-site adjustments was carried out with the Extech Lux Meter EA30 (Extech Instruments Corporation, Nashua, NH, USA).…”

“…Two former reports from our research group introduced an ADL framework for the fundamental assessment of near- and intermediate-vision tasks [ 21 ] and validated it in specific lighting settings (combinations of light intensity (25 fc, 50 fc, 75 fc) (1 fc (foot-candle) = 10.76 lx (lux)) and light temperature (3000 K, 4000 K, and 6000 K)) [ 22 ] ( Table 1 ). The vision capacity of examinees for this ADL framework was measured by two general scales that standardize the participants’ score for any given ADL; the first scale uses the task duration (time required to complete a task) or a combination of task duration with the number of errors made during each task, and the second scale uses the measured number of errors.…”

“…Additionally, it has been shown that visual acuity is significantly correlated with ADL performance. Specifically, a validation study of a framework including ADLs that require near and intermediate vision capacity has proved that patients with perfect near visual acuity have the best ADL scores among three groups of near visual acuity, followed by the group with moderate and low near visual acuity [ 22 ]. Visual performance in different ADLs is also affected by lighting conditions.…”

“…Visual performance in different ADLs is also affected by lighting conditions. Specifically, a significant difference in ADL score has been revealed among three different lighting combinations of progressively higher light intensity and higher lighting color temperature (cooler light) in ADLs using printed material, while no difference has been revealed in almost all ADLs using screens or needing manual dexterity [ 22 ].…”