COSMIN database

Vision-specific instruments for the assessment of health-related quality of life and visual functioning: a literature review

Margolis, M. K., Coyne, K., Kennedy-Martin, T., Baker, T., Schein, O., and Revicki, D. A.
Clinically objective measures such as visual acuity or visual field provide an assessment of a patient's visual status. However such measures may not reflect the degree of visual impairment the patient experiences in his or her daily activities. Visual impairment has been shown to have negative effects on health-related quality of life (HR-QOL) and a significant impact on daily functioning, including social activities. As such, there is a growing recognition of the importance of patient-reported outcomes of visual functioning. This review examines the development and psychometric properties of 22 vision-specific instruments assessing visual functioning and/or the impact of visual impairment on HR-QOL or daily activities. Issues relevant to assessing vision-specific subjective outcomes are reviewed, with specific application of the reviewed instruments. Three instruments, the Activities of Daily Vision Scale, National Eye Institute Visual Function Questionnaire, and Visual Function Index have been well validated and widely used, but others also show promise. To fully capture the benefits of a new ophthalmology treatment (or new treatment for eye disease) a valid and reliable visual instrument, in which the psychometric performance has been demonstrated in the particular ocular condition being treated, should be utilised.
1170-7690 (Print)
Publication year:
Functional status:
Physical functioning
General health perceptions / HRQoL:
Health-related quality of life
Adults (18-65)
Children (0-18)
Seniors (65+)
Diseases of and symptoms related to the eye and adnexa
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
6 - Clinical rating scales
ADVS - Activities of Daily Vision Scale
ASCRS-ACDCF - American Society of Cataract and Refractive Surgery–Cataract Data Collection Form
Catquest (versions: Catquest-9SF)
CSS - Cataract Symptom Scale
DLTV - Daily Living Tasks Dependent Upon Vision
GO-QOL - Graves’ Ophthalmopathy-specific Quality of Life
HVAT - Houston Vision Assessment Test
IVI - Impact of Vision Impairment
Miedziak’s instrument
MIOLS-HR-QOL - Madurai Intraocular Lens Study – Health-Related Quality of Life Questionnaire
MIOLS-VF - Madurai Intraocular Lens Study-Visual Functioning Questionnaire
MOOD - Measure of Outcome in Ocular Disease
NEI VFQ-25 - 25-item National Eye Institute Visual Function Questionnaire
NEI VFQ - National Eye Institute Visual Function Questionaire (versions: NEI VFQ-9 items)
RSVP - Refractive Status and Vision Profile
SIPV - Vision-Specific Sickness Impact Profile
Turano’s instrument
van Dijk’s instrument
VAQ - Visual Activities Questionnaire
VDA - Visual Disability Assessment
VDQ - Visual Disabilities Questionnaire
VF-14 - Visual Function Index-14 (versions: VF-7)
VQOL - Vision-Related Quality of Life Questionnaire