Just about every vitreoretinal surgeon can think of a patient who underwent a successful retinal detachment repair—perhaps even resulting in 20/20 visual acuity—but reported suboptimal visual function. Surgeons often use the word successful to describe patient outcomes that meet or exceed certain objective criteria; for rhegmatogenous retinal detachment (RRD) repair, the focus is often primarily on anatomic reattachment and secondarily on best-corrected visual acuity levels. While these are important measures, they represent surgeon-set metrics rather than patient-reported parameters. We place so much emphasis on how many letters in a bright white box a patient can identify while sitting in an artificially darkened room yet fail to account for 99% of their vision-dependent daily activities, such as driving, reading, and socializing. There is growing interest in patient-centered functional outcomes for a variety of retinal conditions, including macular degeneration, epiretinal membrane, and diabetic macular edema, because it is clear that visual acuity is far more complex than just the number of letters one can read on a chart.
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Weng CY. Vision-Related Function Following Retinal Detachment Repair—Looking Beyond the Letter Chart. JAMA Ophthalmol. Published online June 18, 2020. doi:10.1001/jamaophthalmol.2020.2023
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