Quality of life of the most severely vision-impaired.

Background: To explore the interaction between vision impairment, perceived quality of life loss and willingness to trade remaining life for vision gain.

Design: Community-based cross-sectional study.

Participants: Legally blind or severely vision-impaired people selected randomly from the Association for the Blind of Western Australia register.

Methods: Individuals were examined by consultant ophthalmologists and completed the Impact of Vision Impairment profile quality of life assessment and a Time Trade-Off evaluation. Vision-related utility values were calculated. The results were analysed using univariate and multivariate regression methods.

Main Outcome Measures: IVI Rasch Logits and TTO utility values (TTO UV).

Results: 156 people volunteered to contribute to the study. The median age was 80 (19-97) years, and 56% were female. Being legally blind (logMAR > 1) (95% CI 1.1 to 5.2, P = 0.003), clinically depressed (95% CI -11.2 to -1.8, P = 0.007) or more than 40 years of age (95% CI 0.9 to 8.1, P = 0.015) significantly lowered overall impact of vision impairment scores. The emotional domain of impact of vision impairment was associated with willingness to trade part of remaining life. A 5-Logit increase in impact of vision impairment emotional score resulted in a 21% (95% CI 10 to 31) decrease in the odds of being likely to trade life for sight. The Australian definition of blindness compared with World Health Organisation or USA best separates those with perceived loss and appears useful in identifying vision loss-related morbidity.

Conclusions: These results suggest that emotional health and lack of depression are important determinants for quality and value of life.