AMD-related vision loss associated with restriction of travel

This study found that AMD-related visual acuity loss but not glaucoma-related visual field loss was associated with restriction of travel to more nearby locations. The authors conclude that this geographic constriction may impact quality of life and restrict access to services.

The study’s findings are reflective of my patients in that those with decreased vision from AMD limit themselves more than those with advanced glaucomatous visual field changes. This is probably due to the fact that those with glaucoma still have relatively spared central vision and therefore feel that it is safe for them to drive and travel more than those with decreased central vision from AMD. It is also possible that those with central loss from AMD are discouraged by not being able to see and therefore don’t find travel as interesting or perhaps find it more difficult and less productive as they can’t see things like price tags and names of products at the store.

Subjects were 61 controls with normal vision, 84 subjects with glaucoma with bilateral visual field loss, and 65 subjects with AMD with bilateral or severe unilateral loss of visual acuity. The authors used a cellular tracking device to track their location every 15 minutes between 7 a.m. and 11 p.m. for seven days.

They found that worse visual acuity due to AMD was associated significantly with restriction of travel to nearby destinations, with each one-line (0.1 logMAR) decrement in better-eye visual acuity associated with an approximately one-quarter–mile decrease in average excursion size and span for away-from-home travels. However, no associations were observed between average excursion size and span with severity of better-eye visual field loss resulting from glaucoma.

Being married or living with someone and younger age were associated with more distant travel, while less-distant travel was noted for older individuals, African-Americans, and those living in more densely populated regions.

The study’s findings suggest that vision impairment from AMD might result in, or reflect, social isolation and difficulty accessing health care services outside the home. They also suggest that travel restriction may worsen with disease severity but may not be substantially affected at early stages of disease.