Any self-reported problem relating to vision may constitute a quality of life issue. A modular approach to item selection may provide the flexibility to investigate vision-related quality of life in a wide range of clinical settings, allowing detailed assessment of specific problems and also cross-study comparisons where appropriate.

Purpose To examine the distribution in the population of indications for cataract extraction in order to relate demand for this procedure to the capacity for satisfying it.Methods An age-stratified random population The existing record in ophthalmological epidemiology offers good data on the population distribution of eye disease,9-11 but the uncertain relationship between pathology and the capacity to benefit from surgery means that such data provide only a limited basis for judging the requirement for cataract extraction.This study was designed to examine the relationship between the potential demand and the supply of cataract extraction surgery.Eye (2001) 15, 745-752

Waterclefts and retrodots are independently associated with visual impairment, yet a review identified no data on risk factors. Purpose To investigate risk factors for these two human lens cataract subtypes. Method Two nested case-control studies: The host study comprised 1078 subjects (Z55 years) attending the Somerset and Avon Eye Study (SAES). In total, 197 watercleft cases (ZOxford grade 0.2 in either eye) and 199 retrodot cases (ZOxford grade 1.0 in either eye) were individually age/gender matched to controls. Detailed ophthalmic and potential risk factor data were collected, including body mass index (BMI), smoking, alcohol, diabetes, hypertension, analgesics, vitamin supplementation, nutrition, sunlight exposure, dehydration, hormonal (women), blood lipids, glucose, urea, creatinine, uric acid, and vitamin levels. Results For waterclefts, univariable analysis identified BMI, alcohol intake, vitamin status, sunlight, urea, creatinine, and uric acid as possible risk factors. Multivariable analysis identified two independent associations. Total number of 'any' analgesics in the previous year: adjusted Po0.01 (U-shaped risk profile, unadjusted high vs medium use ( ¼ reference) OR 2.39, 95% CI 1.35-4.26 with medium use vs none ( ¼ reference) OR 0.43, 95% CI 0.26-0.72); total sunlight: adjusted P ¼ 0.03 (unadjusted highest exposure vs lowest ( ¼ reference) OR 3.25, 95% CI 1.11-9.50). For retrodots, univariable analysis identified alcohol, HRT, and lipids. Multivariable analysis identified two independent associations. Mean number of alcohol units consumed per month, adjusted P ¼ 0.02 and HDL cholesterol levels, adjusted P ¼ 0.02 (unadjusted ORs NS both).Conclusion This is the first available published information on risk factors for the human cataractous lens features waterclefts and retrodots.