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The Role of vision and refractive correction changes in dizziness

Dizziness is a common, multifactorial problem that causes reductions in
quality of life and is a major risk factor for falls, but the role of vision is a very
under-researched area. This study aimed to investigate any link between
dizziness and vision and to establish if changes in spectacle lens correction
could elicit dizziness symptoms.
A link between dizziness and self-reported poor vision was indicated in the
epidemiological literature as shown by a systematic review, provided lightheadedness
was not included in the definition of dizziness. Cases of
individuals who reported vision-related dizziness were investigated to
determine potential areas of research for this thesis and subsequently two
studies investigated the effects of refractive correction changes on dizziness
status. The first study was limited by logistical problems, although it
highlighted limitations in the short form of the Dizziness Handicap Inventory
that was used to quantify dizziness. Results of an optometry practice recheck
study found that oblique cylindrical changes were significantly more likely to
be associated with dizziness symptoms than other spectacle lens changes. It
also highlighted that optometrists do not ask/record about dizziness symptoms
with only 4% of records including “dizziness” as a problem when 38% of
patients reported dizziness symptoms when directly asked. All studies
highlighted a need for a patient-reported outcome measure to be designed to
assess vision-related dizziness. Literature review, interviews with experts and
patients and focus groups led to the development of a pilot questionnaire and
subsequently a 25-item Vision-Related Dizziness instrument, the VRD-25.
This was validated using responses from 223 respondents, with 79
participants completing the questionnaire a second time to provide test-retest
data. Two subscales of VRD-12-frequency (VRD-12f) and VRD-13-severity
(VRD-13s) were shown to be unidimensional and had good psychometric
properties, convergent validity and test-retest repeatability. The VRD-25 is the
only patient-reported outcome measure developed to date to assess vision related
dizziness and will hopefully provide the platform to further grow this
under-researched area that seems likely to provide important clinical
information. / College of Optometrists sponsored the research with a Postgraduate Research Scholarship

Identiferoai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/16956
Date January 2018
CreatorsArmstrong, Deborah
ContributorsElliott, David B., Alderson, Alison J.
PublisherUniversity of Bradford, Bradford School of Optometry and Vision Science
Source SetsBradford Scholars
LanguageEnglish
Detected LanguageEnglish
TypeThesis, doctoral, PhD
Rights<a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/"><img alt="Creative Commons License" style="border-width:0" src="http://i.creativecommons.org/l/by-nc-nd/3.0/88x31.png" /></a><br />The University of Bradford theses are licenced under a <a rel="license" href="http://creativecommons.org/licenses/by-nc-nd/3.0/">Creative Commons Licence</a>.

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