Abstract

Removal of cataracts may not improve visual acuity if the patient also has a macular, optic-nerve, or optic-pathway disease. However standard clinical tests often fail to detect these other diseases in cataract patients, especially in patients with dense cataracts. We assessed the diagnostic value of the patient's age and of a test battery that included use of the laser interferometer, potential-acuity meter, blue-field entoptoscope, and bright-flash visual evoked potentials (VEPs). Discriminant analysis allowed us to determine (1) how well these measures can discriminate cataract patients who have other vision-related diseases from those who do not and (2) which of these measures is most effective in making this discrimination. Our heterogeneous sample consisted of 112 cataract patients who underwent cataract surgery and suffered no surgical or postsurgical complications. Thirty-eight of these cataract patients (34%) had, or were shown later to have had, macular, optic-nerve or optic-pathway disease. Using Bayes' rule to maximize the overall probability of correct categorization, 72-76% of the cataract patients were accurately categorized. The discriminant analysis, however, was more accurate in categorizing cataract patients who did not have other vision-related diseases than it was in categorizing those who did. Moreover, only bright-flash VEPs were effective in making this discrimination.

© 1990 Optical Society of America