Assessment of the Abbreviated National Eye Institute Visual Function Questionnaire (NEI VFQ 9) in blepharoptosis and dermatochalasis

Abstract

Purpose: To evaluate the Abbreviated National Eye Institute Visual Function Questionnaire (NEI VFQ 9), which is shorter than those previously published, as a tool for assessing vision-related quality of life in patients with ptosis and der matochalasis. Methods: This is a cohort study of 46 patients who underwent blepharoptosis and/or upper eyelid blepharoplasty surgery by a single surgeon (CN) in 2013 in a public, academic, ambulatory care referral center. Patients included 29 who underwent blepharoplasty, 11 who underwent ptosis surgery, and 6 who underwent combined surgery. The NEI-VFQ 9 was administered pre-and postoperatively, and the composite scores were compared using Student's t-test. Survey duration was timed in a subset of patients. The hypothesis was that the NEI VFQ 9 could detect a statistically significant improvement in composite score after surgical intervention. Results: The mean pre-and postoperative NEI VFQ 9 composite scores were 74.9 and 86.8, respectively, in the blepharoplasty-only group (P<0.0001), 72.07 and 86.41, respectively, in the ptosis-only group (P=0.004), and 75.8 and 87.2, respectively, in the combined group (P=0.022). There was no correlation between the gain in composite score and the change in upper eyelid margin to reflex distance. Twenty-five patients were timed filling out the survey, and the mean was 2.3 min. Conclusions:The NEI VFQ 9 consistently demonstrates a significant increase in visual function for blepharoptosis and dermatochalasis patients. Thus, it may be a useful tool for assessing vision-related quality of life in patients with ptosis and dermatochalasis. Keywords INTRODUCTIONQuality of life (QoL) measurements in oculoplastic surgery are be coming increasingly relevant, given the evolving healthcare and payer systems in the United States. Several instruments have been used to measure QoL outcomes in ptosis repair and upper blepharoplasty. They consistently demonstrate that these surgical interventions have a real and measureable positive impact on vision-related QoL (1)(2)(3)(4) . The previously employed instruments have ranged from published ophthalmic QoL instruments, such as the NEI-VFQ-25(1) , to specifically designed ptosis and dermatochalasis instruments adapted from other QoL instruments (2)(3)(4) . No prior study has timed the patients as they complete these questionnaires, which range in length from 25 to 36 items. The NEI-VFQ-25, which is one of the most commonly used ophthalmic QoL instruments, has been vetted in a number of conditions, including cataract, glaucoma, and age-related macular degeneration (5-12) . Asano and Osaki demonstrated that it is also sensitive

Blepharoptosis among Korean adults: Age-related prevalence and threshold age for evaluation

“…Moderate to severe blepharoptosis can impair visual function (e.g., loss of superior visual fields) [6] cause psychological distress (e.g., anxiety and depression) [5], reduce health-related quality of life [18], and cause tension-related headaches [7][8][9]. Blepharoptosis in older adults may be underestimated or ignored because both physicians and patients consider the condition to be a result of the aging process.…”

Blepharoptosis among Korean adults: age-related prevalence and threshold age for evaluation

“…Richards et al reported that patients with blepharoptosis had higher levels of anxiety, depression, and concerns regarding their appearance than the general population [5]. When questioned about their visual function-related quality of life, Briceño et al reported that after surgery for ptosis repair, patients reported a significant increase in visual function [6]. Based on these findings, physicians should be concerned about appearance-related distress and compromised psychological well-being among patients with ptosis.…”

Digital Image Analyses of Preoperative Simulation and Postoperative Outcome following Blepharoptosis Surgery

“…The problems associated with blepharoptosis are not only its negative cosmetic effect but also its negative effect on the quality of vision and on the quality of life. 2 , 3 Evidence has been accumulating on the negative changes, including the reduction in the size of the visual field, alterations of the corneal topography, and decrease in the contrast sensitivity in patients with blepharoptosis. 4 …”