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Sarah R. Wellik, Bozorgmehr Pouyeh, Huan Guan, Anat Galor; Impact Of Ocular Surface Disease On Quality Of Life In Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2012;53(14):566.
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To evaluate the impact of ocular surface symptoms on quality of life in patients receiving topical glaucoma medications.
This is a cross-sectional, survey study conducted at the Miami Veterans Affairs Medical Center (VAMC). Patients seen at the eye clinic between June and August 2010 were asked to fill out the dry eye questionnaire 5 (DEQ5) and the Impact of Dry Eye on Everyday Life (IDEEL) questionnaire. The main outcome measure was evaluation of the correlation between ocular surface symptoms and functionality in those with and without glaucoma medication usage.
Four hundred eighty-nine patients elected to fill out the DEQ5 questionnaire (36% response rate). The mean age of respondents was similar in those using and not using glaucoma medications (65±13 versus 67±11 years, P-value 0.13). Likewise, a similar percent of patients were male (using drops 96% (n=120); not using drops 94% (n=312)) and Hispanic (using drops 11% (n=14); not using drops 16% (n=50)). Blacks were more likely to use glaucoma medications than whites (58% (n=68) versus 29% (n=89), p-value <0.0005. Using the DEQ5 as a surrogate measure of ocular surface symptoms, 35% of patients on glaucoma medications reported severe symptoms (DEQ5≥12) compared to 24% not on glaucoma medications (p-value 0.03). Furthermore, an increasing number of glaucoma medications were associated with an increased percentage of severe symptoms (none: 24%, 1 drop: 28%, 2 drops: 31%, 3 drops: 30%, 4 drops: 48%, linear-trend p-value 0.002). In a multivariable analysis considering the various glaucoma medications, brimonidine use remained the only significant predictor of severe symptoms (OR 2.26, 95% CI 1.27-4.0, p-value 0.005). There were significant differences in IDEEL scores between respondents with and without glaucoma medication use with regards to emotional well-being (mean, 78±27 versus 85±22, p-value 0.02), but not with regards to performing activities (mean, 85±21 versus 86±18, p-value 0.74), and capacity to work (mean, 85±23 versus 85±23, p-value 0.97).
Patients taking glaucoma medications were more likely than those not on glaucoma medications to suffer from severe dry eye symptoms on a standardized dry eye questionnaire and these patients also had significantly lower scores for emotional well-being. Severe symptoms were associated with both the number and type of glaucoma medications used. These factors are likely to influence both medication compliance and quality of life in patients with glaucoma.
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