Vision- and health-related quality of life in patients with visual field impairments after lesions to the central visual pathway

As the population ages and the average lifespan lengthens there is an increasing number of patients with visual field impairments caused by different etiologies. Especially mortality from stroke has been declining over recent decades. Therefore, more people have to face the challenge of adapting to vision impairments after cerebral lesions. Visual field loss (VFL) leads to impairments in activities of daily life (ADL) such as reading, driving, or overall orientation and may also have a severe impact on the patients` well-being and quality of life (QoL). While there are many studies assessing self-rated disabilities after stroke, using questionnaires of general health-related QoL, only few studies focused on the assessment of vision-related QoL in patients with VFL after cerebral damage. Vision-related QoL was often described in patients with different ophthalmologic diseases especially glaucoma, cataract, and age-related macular degeneration. In these studies, the National Eye Institute - Visual Function Questionnaire (NEI-VFQ) was often used as a valid and reliable instrument for the assessment of vision-related QoL. Diminished visionrelated QoL was observed in each of the mentioned ophthalmologic diseases even when age was considered as possible confounding variable. A literature review was performed to collect information on vision-specific QoL questionnaires to select an appropriate instrument for studying the relationship between VFL after cerebral damage and vision-specific QoL. The NEI-VFQ was selected because this questionnaire was already used in patients with damage to the central visual pathway. Additionally, substantial correlations between self-reported visual functioning in the NEI-VFQ and VFL were reported in a large number of studies on ophthalmologic diseases with VFL.