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Purpose: To determine the relationship between clinical measures of vision impairment and the ability to perform activities of daily living (ADLs). Methods: One hundred and twenty subjects with low vision from a variety of causes participated in the study. Vision impairment was assessed under binocular conditions by measuring distance visual acuity, near word acuity, Melbourne Edge Test contrast sensitivity, Pelli-Robson Chart contrast sensitivity and visual fields. The ADL performance was assessed using the Melbourne Low Vision ADL Index (MLVAI), which is in part an observed performance assessment of instrumental ADLs and in part a self-report assessment of basic self-care ADLs. Results: All vision measures had a high, statistically significant correlation with MLVAI total score. Near word acuity, had the strongest correlation (r s = -0.86, p < 0.001), followed by Melbourne Edge Test contrast sensitivity (rs = 0.80, p< 0.001). Visual field had the weakest correlation (rs = 0.56, p< 0.001). Together, age, near word acuity, Melbourne Edge Test contrast sensitivity and visual field accounted for 82.2% (adjusted R2, p < 0.001) of the variance in MLVAI total score. All correlations obtained were higher for the observed performance assessment of instrumental ADLs than for the self-report assessment of basic self-care ADLs. Conclusions: Clinical vision impairment measures are highly correlated with capacity to perform ADLs, as measured by the MLVAI. © 2002 The College of Optometrists.

Objective. To develop a version of the Melbourne Low-Vision ADL Index that measures the personal impact of disability in activities of daily living (ADL's). Also, to determine the relationship between clinical measures of vision impairment and disability impact. Methods. The Melbourne Low-Vision ADL Index (MLVAI) is a desk-based clinical assessment of disability in ADL's. Ability to perform each item is rated on a five-level descriptive scale from zero to four. In this study, the original version of the MLVAI was modified to measure disability impact. The simple modification involved weighting each item by the importance of that item to the person being tested. Importance was also rated on a five-level scale from zero to four. The validity and reliability of the Weighted Melbourne Low-Vision ADL Index (MLVAIw) was determined for 97 vision-impaired subjects in a cross-sectional study. Results. Cronbach's alpha coefficient indicated an internal reliability of 0.94, and an intraclass correlation coefficient indicated an overall reliability of 0.88. The standard error of measurement was 24.7 points (out of a possible score of 400). There was a statistically significant difference in test scores between normal subjects and vision-impaired subjects. All vision measures had a high, statistically significant correlation with MLVAIw score. Near-word acuity had the strongest correlation (rs = 0.78, p < 0.001), followed by Melbourne Edge Test contrast sensitivity (rs = -0.72, p < 0.001). Visual field had the weakest correlation (rs = -0.52, p < 0.001). The best predictive model of MLVAIw score incorporated the variables age, near-word acuity, and visual field. Together, these variables accounted for 65.1% of the variance in MLVAIw score. Conclusions. The MLVAI is highly valid and reliable when weighted by a scale that reflects the personal importance of ADL's. The MLVAIw can provide information over and above that obtained with the usual clinical vision measures and may be use

Purpose. To conduct a preliminary investigation on the ability of the Melbourne Low Vision ADL Index to detect changes in functional ability as a result of low-vision rehabilitation. Methods. Twenty two subjects with age-related macular degeneration (ARMD) who were newly referred to the Kooyong Low Vision Clinic were recruited. The Melbourne Low Vision ADL Index was administered prerehabilitation and postrehabilitation. Changes in scores and effect size statistics were analyzed. Results. The median total score for the subjects prerehabilitation was 67, and the median total score postrehabilitation was 76. The difference in prerehabilitation and postrehabilitation scores was statistically significant (Wilcoxon signed rank test = 248.5, p < 0.001). The mean change score for the total Melbourne Low Vision ADL. Index was 9.3 (SD, 5.6). Thus the overall effect size statistic (mean change score divided by SD of prerehabilitation score) was 0.78. Conclusions. This preliminary investigation indicates that the Melbourne Low Vision ADL Index is responsive to a rehabilitation program for patients with ARMD. It has potential to be used as a measure of low-vision rehabilitation outcomes.

Free to read at publisher's site. The responsiveness of the Melbourne Low Vision ADL Index (MLVAI) to clinically important changes, produced as a result of programs implemented in a low vision clinic, was assessed. MLVAI was administered on 22 subjects on two occasions. Preliminary results suggest that the test is responsive to change for subjects with AMD and that it has potential as an outcome measure of low vision rehabilitation programs.

The relationship between orientation and mobility (O and M) performance and residual vision is not clearly understood. Intuitively, good vision should result in good O and M, and little or no vision should result in poor O and M. However, the literature suggests a more complicated picture. The authors propose that certain psychological variables, such as particular personality traits and intelligence, may account for some of the complexity. This article reviews previous work in this area and outlines directions for future research.