All ETDs from UAB

Advisory Committee Chair

Lei Liu

Advisory Committee Members

Elizabeth Barstow

Nataliya Ivankova

Mark Swanson

Roderick Fullard

Document Type

Dissertation

Date of Award

2020

Degree Name by School

Doctor of Philosophy (PhD) School of Optometry

Abstract

According to the United States Administration on Aging (AOA, 2014), the population of individuals over 65 will be 98 million by the year 2060, doubling its 2014 estimates. As our population ages, the prevalence of glaucoma increases. Vision loss resulting from glaucoma can limit participation in valued occupations including engagement in reading. It has long been thought that mobility issues and glare sensitivity were the main factors that characterized glaucoma. In the late 1990s and early 2000s researchers began to examine quality of life (QoL) in those with glaucoma. It was during these early QoL studies that the first reports of central vision issues were reported among adults with glaucoma. The QoL studies show that the concerns of those with glaucoma are associated with the vulnerability of central vision as the disease progresses, and not with the consequences of visual field loss that are commonly thought to characterize the disease. The most frequently reported problems with vision from many of the QoL questionnaires have been related to lighting and glare. These factors have been assessed as less important by patients when judged within the context of several vision-related factors. The findings that patients are concerned about the vulnerability of central vision (reading and near tasks) rather than the characteristic features of visual field loss (mobility) suggests that the focus of rehabilitation should not simply be on mobility, as it is only addressing part of the problem. Some studies have been completed with the goal of identifying the components of reading that are affected by glaucoma (i.e., contrast sensitivity function), most significantly reading endurance. There are very few studies that have explored how these changes in reading affect the person’s ability to perform specific occupations. These studies have also not examined the perspectives of persons with glaucoma of how their occupational performance is affected by reading loss. The purpose of this exploratory mixed methods research study was to develop a new, reliable and content validated instrument to measure the effects of reading impairment associated with glaucoma on occupational performance in older adults in a metropolitan area of a Southeastern state. The product of the study was a newly developed, initially validated and reliable instrument to assess reading changes associated with glaucoma and the effect on occupational performance. The insights gained from the data aided in understanding the problems that arise from an inability to read and the effects on occupational performance. This information could be used to determine treatment interventions that can be designed to reduce the effects of inability to read on occupational performance.

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