How do different lighting conditions affect the vision and quality of life of people with glaucoma? A systematic review

Abstract

from eligible studies regarding study design, participant characteristics, outcomes and results. Quality of included studies was critically appraised. Of 8437 studies, 56 eligible studies were included. Studies investigated the effects of lighting on the following themes among people with POAG: QoL (18/56), psychophysical measures (16/56), functional vision (10/56), activities of daily living (10/56) and qualitative findings (2/56). POAG negatively affects low-luminance contrast sensitivity, glare symptoms, and dark adaptation time and extent. In vision-related QoL questionnaires, people with POAG report problems with lighting, glare and dark adaptation more frequently than any other domain. These problems worsen with progressing visual field loss. Early-stage POAG patients experience significantly more difficulties in low-luminance or changing lighting conditions than age-matched controls (AMCs), challenging perceptions of early-stage POAG as asymptomatic. However, performance-based studies seldom show significant differences between POAG participants and AMCs on tasks simulating daily activities under non-optimal lighting conditions. Further research with larger samples is required to optimise ambient and task-oriented lighting that can support patients' adaptation to POAG.

Concept Mapping to Identify Content for a Performance-Based Measure of Low Luminance Vision-Related Activities of Daily Living

“…To date, adaptation to light levels has been limited to a few performance-based mobility 41 – 43 and driving studies 41 – 46 investigating glare disability, in spite of it being such a frequently reported problem for patients with vision impairment. 3 , 5 , 16 , 17 , 47 …”

“… 1 – 4 Even in the early stages of eye disease, adults with vision impairment report difficulties with night driving, walking at night, seeing steps, reading under dim illumination, glare, and adapting to changes in illumination. 1 , 3 , 5 , 6 The consequences can be serious, including motor vehicle collisions, particularly involving pedestrians and cyclists, 7 , 8 falls, 9 – 12 and emotional distress. 5 , 13 Measuring these effects has become increasingly important to better understand the problems experienced by adults with vision impairment under low luminance, to design interventions to prevent physical and psychological injury and to develop measures for evaluating and monitoring changes in performance following eye therapies and vision interventions.…”

Seeing other perspectives: evaluating the use of virtual and augmented reality to simulate visual impairments (OpenVisSim)

“…An ideal simulator would also take into account the fact that, for many patients, the extent/quality of their vision loss varies, depend on their own physiological state or their current viewing conditions (e.g., level of ambient illumination). Thus, it has been observed that some glaucoma patients exhibit a greater loss of vision under home-lighting, than when assessed in a well-lit eye clinic 37,38 .…”

Non-Glaucomatous Causes of Decreased Vision in Glaucoma

“…Sometimes, instead of reporting these symptoms, the patients complain of blurred vision and increased requirement of light for work. 13 Lack of awareness about the disease and poor socioeconomic conditions of the patients contribute to late presentation. This may be the possible reason that treatable and reversible causes of decreased vision in glaucoma patients remain undiagnosed, untreated and overlooked.…”