Assessing disability in the patient with cataracts.

Snellen chart visual acuity has been the gold standard to measure the preoperative indication of cataract surgery as well as the postoperative outcome. To a patient with cataracts, the disability goes beyond their loss of visual acuity. Glare disability has often been studied independently. Newer studies, however, show that there is more integration with clinical and nonclinical vision. For example, studies are looking at integrating unilateral versus bilateral procedures, type of cataract, type of procedure, the patient's daily needs, and the patient's state of mental and physical health. Questionnaires are being developed to bring into focus nonclinical issues of visual function and quality of life. Understanding the full spectrum of disability associated with visual impairment from cataracts can help clinicians improve their approach to treatment and rehabilitation of these patients.