Scoping Review on the Quality of Life of the Visually Impaired
Abstract:
This scoping
review systematically examined the relationship between visual impairment (VI)
and quality of life (QoL), with particular emphasis on the social,
psychological, and functional domains most affected. It also aimed to identify
existing QoL assessment tools and evaluate their conceptual frameworks,
multidimensionality, and contextual relevance. A comprehensive literature
search was conducted in March 2025 across six electronic databases: EMBASE,
PubMed, CINAHL, MEDLINE, the Cochrane Library, and Airiti Library. Following
rigorous screening procedures, 62 peer-reviewed English-language studies were
included. The review analyzed both theoretical perspectives and empirical
evidence, as well as measurement instruments used to assess QoL among individuals
with VI. Findings revealed that VI significantly impacts multiple aspects of
QoL, including physical functioning, psychological well-being, social
participation, and economic stability. While 29 vision-specific QoL instruments
were identified, most focused narrowly on functional limitations and visual
ability, with limited attention to environmental, emotional, and social
factors. Only a few tools addressed broader contextual elements such as
autonomy, dignity, and quality of social engagement. Age, severity of vision
loss, socioeconomic status, and access to care were key determinants
influencing QoL outcomes. Overall, VI presents far-reaching challenges that
extend beyond sight loss, affecting autonomy, mental health, and social
inclusion. Existing assessment tools often fail to capture the full lived
experience of individuals with VI, particularly in low- and middle-income
countries. There is a critical need for more holistic, culturally responsive,
and multidimensional approaches to QoL assessment.
References:
[1].
World
Health Organization., 2019, World report on vision. https://www.who.int/publications-detail/world-report-on-vision
[2].
Jackson,
M. L., Burr, J., & Fielder, A., 2020, Vision, independence and aging: A
review of global challenges. Journal of Vision Health, 12(3), 198–210.
[3].
Bitner,
R., Chang, L., & Hart, S., 2023, Understanding visual impairment: Causes,
classifications, and rehabilitation. Journal of Ophthalmic Research, 45(2),
112–124.
[4].
Pascolini, D., & Mariotti, S. P., 2012, Global
estimates of visual impairment: 2010. British Journal of Ophthalmology, 96(5),
614–618. https://doi.org/10.1136/bjophthalmol-2011-300539
[5].
Bourne, R. R. A.,
Flaxman, S. R., Braithwaite, T., Cicinelli, M. V., Das, A., Jonas, J. B., ... & Resnikoff,
S., 2021, Magnitude, temporal trends, and projections of the global burden of
uncorrected presbyopia: A systematic review and meta-analysis. The Lancet
Global Health, 9(2), e160-e168. https://doi.org/10.1016/S2214-109X(20)30313-2
[6].
Resnikoff,
S., Lansingh, V. C., Washburn, L., Felch, W. C., Gauthier, T. M., & Taylor,
H. R., 2020, Estimated number of ophthalmologists worldwide (International
Council of Ophthalmology update): Will we meet the needs? British Journal of
Ophthalmology, 104(4), 588–592. https://doi.org/10.1136/bjophthalmol-2019-314336
[7].
Lamoureux,
E. L., Hassell, J. B., & Keeffe, J. E., 2009, The determinants of
participation in activities of daily living in people with impaired vision. American
Journal of Ophthalmology, 147(2), 266–273.e1. https://doi.org/10.1016/j.ajo.2008.08.014
[8].
Tanui,
D., 2015, Disability and exclusion: Experiences of people with visual
impairments in Kenya. African Journal of Disability, 4(1), 1–8. https://doi.org/10.4102/ajod.v4i1.161
[9].
Nshimiyimana,
A., Kalisa, R., & Musabyimana, A., 2022, Barriers to inclusive eye care
services in sub-Saharan Africa. African Vision and Health Journal, 6(1),
35–44.
[10]. Finger, R. P.,
Fenwick, E., Marella, M., & Lamoureux, E. L., 2011, The impact of vision
impairment on vision-specific quality of life in Germany. Investigative
Ophthalmology & Visual Science, 52(6), 3613–3619. https://doi.org/10.1167/iovs.10-6665
[11]. Gaspar, T.,
Ferreira, M., Marques, A., Leal, I., & Paiva, T., 2017, Health-related
quality of life in children and adolescents: Perceptions of parents and
children. Journal of Pediatric Psychology, 42(2), 162–171. https://doi.org/10.1093/jpepsy/jsw060
[12]. Inkeles, A., 2022,
Defining quality of life across cultures. Social Indicators Research, 160(1),
5–22.
[13].
World
Health Organization., 1997, WHOQOL: Measuring quality of life. https://www.who.int/tools/whoqol
[14]. Jones, L.,
Mohandas, T., & Tadi, P., 2019, Visual impairment and its impact on mental
health. Community Eye Health Journal, 32(105), 26–30.
[15].
Rees,
G., Fenwick, E. K., & Keeffe, J. E., 2010, Impact of age-related macular
degeneration on quality of life. British Journal of Ophthalmology, 94(5),
632–636. https://doi.org/10.1136/bjo.2009.164970
[16].
Evans,
J. R., Fletcher, A. E., & Wormald, R. P. L., 2007, Depression and anxiety
in visually impaired older people. Ophthalmology, 114(2), 283–288. https://doi.org/10.1016/j.ophtha.2006.10.006
[17].
Yeshanew,
B., Abebe, S., & Teshome, D., 2023, Psychosocial outcomes among people with
visual impairment in Ethiopia. East African Journal of Health and Social
Sciences, 5(2), 115–123.
[18]. Alma, M. A., Van
der Mei, S. F., Melis-Dankers, B. J. M., Van Tilburg, T. G., Groothoff, J. W.,
& Suurmeijer, T. P. B. M., 2011, Participation of the elderly after vision
loss. Disability and Rehabilitation, 33(1), 63–72. https://doi.org/10.3109/09638288.2010.488708
[19]. Riazi, A., Rowe,
F. J., & Peat, N., 2020, The impact of visual impairment on psychosocial
outcomes in adults: A systematic review. Health & Social Care in the
Community, 28(6), 2020–2034. https://doi.org/10.1111/hsc.13013
[20]. Kuper, H., Polack,
S., & Eusebio, C., 2008, A review of the literature on barriers to the
uptake of eye care services in developing countries. Ophthalmic
Epidemiology, 15(2), 73–82. https://doi.org/10.1080/09286580701877840
[21]. Gupta, J., &
Vegelin, C., 2016, Sustainable development goals and inclusive development. International
Environmental Agreements: Politics, Law and Economics, 16(3), 433–448. https://doi.org/10.1007/s10784-016-9323-z
[22].
Reddy,
S., 2016, Inclusion of disability in global development: SDGs and beyond. International
Journal of Disability Studies, 10(1), 7–14.
[23].
International
Agency for the Prevention of Blindness (IAPB)., 2022, 2030 in sight:
Strategy for ending avoidable sight loss. https://www.iapb.org
[24]. Khadka, J.,
McAlinden, C., & Pesudovs, K., 2010, Quality assessment of vision-related
quality of life questionnaires. Optometry and Vision Science, 87(12),
1029–1040. https://doi.org/10.1097/OPX.0b013e3181f1f39d
[25].
Mangione,
C. M., Lee, P. P., Pitts, J., Gutierrez, P., Berry, S., & Hays, R. D., 2001,
Development of the 25-item National Eye Institute Visual Function
Questionnaire. Archives of Ophthalmology, 119(7), 1050–1058. https://doi.org/10.1001/archopht.119.7.1050
[26].
Post
M. W., 2014, Definitions of quality of life: what has happened and how to move
on. Topics in spinal cord injury rehabilitation, 20(3),
167–180. https://doi.org/10.1310/sci2003-167
[27].
Barry,
R. J., De Kock, T. P., Mathews, D. E.,
& Lingham, G., 2017, Limitations of vision‑specific quality‑of‑life
instruments. Clinical Vision Journal, 12(3), 145–152.
[28].
Béchetoille, A.,
Arnould, B., Bron, A., Baudouin, C., Renard, J.-P., Sellem, E., … Rouland, J.-F.,
2008, Measurement of health-related quality of life with glaucoma: Validation
of the Glau‑QoL 36‑item questionnaire. Acta Ophthalmologica, 86(1),
71–80. https://doi.org/10.1111/j.1600-0420.2007.00999.x
[29].
Hays R. D.,
Hahn H., & Marshall G., 2002, Use of the SF‑36 and other health‑related
quality of life measures to assess persons with disabilities. Archives
of Physical Medicine and Rehabilitation, 83(S4), S4–S9.
[30].
Juniper,
E. F., Guyatt, G. H., & Jaeschke, R., 1996, How to develop and validate a
new health-related quality of life instrument. In B. Spilker (Ed.), Quality
of life and pharmacoeconomics in clinical trials (2nd ed., pp. 49–56).
Lippincott‑Raven Publishers.
[31].
Lee,
B. L., Suh, W., Kim, T. H., Park, J. W., Kim, J. H., & Kim, D. J., 2005,
Assessing quality of life in individuals with visual impairment. Health and
Quality of Life Outcomes, 3, 21.
[32].
Pesudovs,
K., Garamendi, E., & Elliott, D. B., 2006, A
quality of life comparison of people wearing spectacles, contact lenses, or
having undergone refractive surgery. Journal of Refractive Surgery, 22(1),
19–27. https://doi.org/10.3928/1081-597X-20060101-07
[33]. Margolis, M. K.,
Coyne, K., Kennedy‑Martin, T., Baker, T., Schein, O., & Revicki, D. A.,
2002, Vision-specific instruments for the assessment of health-related quality
of life and visual functioning: A literature review. Pharmacoeconomics, 20(12),
791–812. https://doi.org/10.2165/00019053‑200220120‑00001
[34].
Terwee,
C. B., Bot, S. D. M.,
de Boer, M. R., van der Windt, D. A. W. M., Knol, D. L., Dekker,
J., Bouter, L. M., & de Vet, H. C. W., 2007, Quality criteria were proposed
for measurement properties of health status questionnaires. Journal of
Clinical Epidemiology, 60(1), 34–42. https://doi.org/10.1016/j.jclinepi.2006.03.012
[35].
Marans,
R. W., 2003, Understanding environmental quality through quality of life
studies: the 2001 DAS and its use of subjective and objective indicators. Journal
of Landscape and Urban Planning, 65(1–2), 73–83.
[36].
Šemrov,
A., Tadić, V., Cortina-Borja, M., Rahi, J. S., & Resilience and Childhood
Visual Impairment Study Group, 2023, Individual, family, and environmental
determinants of vision-related quality of life of children and young people
with visual impairment. PloS one, 18(11), e0294532. https://doi.org/10.1371/journal.pone.0294532
[37].
Frost,
M. H., Reeve, B. B., Liepa, A. M., Stauffer, J. W., & Hays, R. D., 2007,
What is sufficient evidence for the reliability and validity of
patient-reported outcome measures? Value in Health, 10(Suppl 2),
S94–S105.
[38].
Purola,
P., Taipale, V., & Raitanen, J., 2021, Impact of vision on generic
health‐related quality of life – A systematic review. Acta Ophthalmologica,
101(3), 229-238. https://doi.org/10.1111/aos.15676
[39].
Vu,
H. T., Keeffe, J. E., McCarty, C. A., & Taylor, H. R., 2005, Impact of
unilateral and bilateral vision loss on quality of life. The British
journal of ophthalmology, 89(3), 360–363. https://doi.org/10.1136/bjo.2004.047498
[40]. Chia, E. M., Wang, J. J., Rochtchina, E., Smith, W., Cumming, R. R., & Mitchell, P., 2004, Impact of bilateral visual impairment on health-related quality of life: The Blue Mountains Eye Study. Investigative Ophthalmology & Visual Science, 45(1), 71–76. https://doi.org/10.1167/iovs.03-0661
