Lighting conditions and perceived visual function in ophthalmic conditions
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MEDICAL OPHTHALMOLOGY
Lighting conditions and perceived visual function in ophthalmic conditions Efrat Fleissig 1,2 & Eddie Appenbrick 1 & Guy Brock 3 & Charles C. Barr 1 Received: 21 July 2020 / Revised: 15 September 2020 / Accepted: 1 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To determine the influence of different lighting conditions on perceived visual function in patients of different age, gender, race, and in various ophthalmic diseases. Methods A prospective study. A survey given to patients seen in general ophthalmic and retina clinics. Patients were asked four questions: Is your vision better, worse, or the same in (1) bright light vs dim light, (2) indoors or outdoors, (3) beginning or end of the day, and (4) sunny or cloudy day? Parameters tested were age, race, gender, visual acuity, and a variety of ophthalmic conditions. Multivariable models for each question were fit using multinomial regression. Association was considered significant if p < 0.05. Results A total of 722 patients were enrolled in the study. Patients with lower vision (LogMAR ≥ 0.3) were more likely to indicate they either had better vision indoors or outdoors compared with better vision patients (LogMAR < 0.1). Patients with pseudophakia were also more likely to indicate they had better vision on a cloudy day (OR = 1.9). White patients had double the odds of selecting bright light compared with others. Males were less likely than females to indicate better vision indoors (OR = 0.62). There were no significant associations with age-related macular degeneration (AMD) in the multivariable model. Conclusions Most patients did not note any difference in lighting conditions, and although there is explanatory rational for some of the findings in this study, those questions concerning lighting conditions or time of day are not useful for screening of disease. Gender and ethnicity were found to have associations with lighting preferences which needs to be further studied. Keywords Visual acuity . Luminance . Contrast sensitivity . Age-related macular degeneration . Retinal disease
Key Messages What is known: The relationship of visual acuity vs luminance has a higher slope in the patient with normal macula and fixation; however, the slope is lower in patients with lower visual acuity or extramacular fixation. What this study adds: In this prospective study, while patients with exudative AMD did not have a strong association in the multivariable model with lighting preference pseudophakic patients were more likely to indicate they had better vision on a cloudy day. White patients had nearly double the odds of selecting bright light, compared with other ethnicity. Males were less likely than females to indicate better vision indoors, but more likely to indicate better vision on a cloudy day.
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00417-020-04960-w) contains supplementary material, which is available to authorized users. * Charles C. Barr
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