The National Eye Institute Visual Function Questionnaire: Experience of the ONTT

purpose. To describe the health-related quality of life, measured with the National Eye Institute Visual Function Questionnaire (NEI–VFQ), of patients several years after the onset of optic neuritis, according to their neurologic and visual status; to assess the relationship between the NEI–VFQ subscales and clinical measures of visual function; and to assess the internal consistency reliability of the NEI–VFQ subscales. methods. The NEI–VFQ was administered to 244 patients 5 to 8 years after treatment for an episode of acute optic neuritis as part of the Optic Neuritis Treatment Trial. Visual acuity, visual field, contrast sensitivity, and color vision were measured at the same time as questionnaire completion. results. The NEI–VFQ scores generally were lower than those reported for a disease-free group. Reported dysfunction was greater when multiple sclerosis was present and when visual acuity was abnormal, supporting the construct validity of the NEI–VFQ. Rank correlations between the NEI–VFQ subscales and clinical measures of visual function were moderate at best. Internal consistency reliability was generally high for most of the NEI–VFQ subscales. conclusions. These findings add support to the use of the NEI–VFQ as a valuable measure of self-reported visual impairment

Psychological stress and other potential triggers for recurrences of herpes simplex virus eye infections

Objective To assess psychological stress and other factors as possible triggers of ocular herpes simplex virus (HSV) recurrences. Design A prospective cohort study nested in a randomized, placebo-controlled, clinical trial. Setting Fifty-eight community-based or university sites. Participants Immunocompetent adults (N = 308), aged 18 years or older, with a documented history of ocular HSV disease in the prior year and observed for up to 15 months. Exposure Variables Psychological stress, systemic infection, sunlight exposure, menstrual period, contact lens wear, and eye injury recorded on a weekly log. The exposure period was considered to be the week before symptomatic onset of a recurrence. Main Outcome Measure The first documented recurrence of ocular HSV disease, with exclusion of cases in which the exposure week log was completed late after the onset of symptoms. Results Thirty-three participants experienced a study outcome meeting these criteria. Higher levels of psychological stress were not associated with an increased risk of recurrence (rate ratio, 0.58; 95% confidence interval, 0.32-1.05; P = .07). No association was found between any of the other exposure variables and recurrence. When an analysis was performed including only the recurrences (n = 26) for which the exposure week log was completed late and after symptom onset, there was a clear indication of retrospective overreporting of high stress (P = .03) and systemic infection (P = .01). Not excluding these cases could have produced incorrect conclusions due to recall bias. Conclusions Psychological stress does not appear to be a trigger of recurrences of ocular HSV disease. If not accounted for, recall bias can substantially overestimate the importance of factors that do not have a causal association with HSV infection