Patient-Reported Visual Function and Vision-Related Quality of Life Across Ophthalmic Diseases: An Exploratory Cross-Sectional Study

Background/Objectives: Patient-reported outcomes (PROs) provide information on subjective visual function that is not fully captured by conventional clinical measures. This exploratory cross-sectional study evaluated item-level responses to an original 11-item questionnaire and their association with vision-related quality of life across ophthalmic diseases. Methods: A total of 262 participants, including patients with glaucoma, age-related macular degeneration, diabetic retinopathy, retinitis pigmentosa, cataract, and individuals with long-standing severe visual impairment, completed the questionnaire and the National Eye Institute Visual Function Questionnaire-25 (VFQ-25). Associations with age, disease category, and better-eye visual acuity were examined using correlation analyses, multivariable regression, and ordinal logistic models. Results: Perceived change in vision after treatment or disease management (A6) showed the most consistent item-level associations. A6 remained associated with age after adjustment for disease category and visual acuity (β = −0.030, p < 0.001), whereas visual acuity was not associated with questionnaire domains. A6 was negatively correlated with the VFQ-25 composite score (r = −0.693, p < 0.001) and remained associated with this score in multivariable analysis (β = −0.230, p < 0.001). Conclusions: Item-level PRO responses varied across clinical backgrounds and were not adequately explained by visual acuity alone. These findings suggest that patient-perceived visual change after treatment or disease management may provide complementary information on vision-related quality of life. Further studies using validated instruments and disease-specific severity measures are needed.