Development and Validation of a Lighting Facility for the Objective Assessment of the Visual Performance of Presbyopic Patients in a Series of Activities of Daily Living

Abstract

Introduction The primary objective of this study is to develop and validate an experimental lighting facility that allows the evaluation of near and intermediate vision in different user-defined illuminance levels. Methods This is a prospective, randomized, controlled study. Normophakic patients populated three validation groups (VGs) according to their binocular uncorrected near visual acuity (UNVA): a) VG1, 0.0-0.1 logMAR; b) VG2, 0.4 logMAR; and c) VG3, 0.7 logMAR. All participants addressed 10 near and intermediate activities of daily life (ADLs) in the three following lighting settings: 1) 25 foot candles (fc)/3000 kelvins (K), 2) 50 fc/4000 K, and 3) 75 fc/6000 K. Results Thirty patients in each group performed all ADLs in the three lighting settings. VG1 demonstrated the best ADL scores in all ADLs and lighting settings, followed by the VG2. VG3 presented the worst scores. ADLs using printed material showed significant differences among the three lighting settings for all study groups, while ADLs using screens or needing manual dexterity demonstrated no significant differences except for the Screwdriver Test (ST) in VG1. All ADL scores demonstrated a high correlation with UNVA in all lighting settings (p < 0.001). Conclusion This is the first study that validates a lighting facility for comparative studies in patients with different near vision capacities performing a series of ADLs.

Keywords: activities of daily living; intermediate vision; light intensity; light temperature; near vision; presbyopia.

Conflict of interest statement

The authors have declared that no competing interests exist.

Copyright © 2022, Labiris et al.

Figures

Figure 1. A three-dimensional (3D) illustration of the examination room with the four luminaires installed on the ceiling at their actual positions. The light intensity on the surfaces inside the room is overlaid and encoded in color according to the chromatic scale shown at the bottom (units: lx) using the RELUX software.

Figure 2. Relative radiant flux distribution of the luminaires in the visible spectrum for a range of light temperatures.

Figure 3. Graphical representation of the scale.

Defined by setting λ = 1/5 and n0 = 10 (steps).

Figure 4. Graphical representation.

Proposed sn scale, applied to the SubRe ADL task.

Figure 5. The application of the proposed scales to the first 5 ADLs.

Left column: Histograms of time duration Middle column: Mapping from duration to the score of the defined time scale (data-points of validation study are overlaid). Right column: Histograms of the scale values of each ADL.

Figure 6. The application of the proposed scales to the rest 5 ADLs.

Left column: Histograms of time duration (for the 4 ADLs) and histogram of the number of errors (for SubRe). Middle column: Mapping from duration or number of errors to the score of the defined time scale or error scale (data-points of validation study are overlaid). Right column: Histograms of the scale values of each ADL.