Abstract
Purpose: :
To assess the quality of life (QoL) in newly diagnosed patients of primary adult glaucoma using the Indian vision function questionnaire (IND-VFQ33) and evaluate the impact of topical ocular hypotensive therapy on it (QoL).
Methods: :
The IND-VFQ33 was used to evaluate the QoL in 62 newly diagnosed glaucoma patients and 60 healthy controls. The IND-VFQ33 is a 33 item QoL assessment tool and is divided into three domains: general functioning, psychosocial impact and visual symptoms. Patients and controls aged 40 years or above, with visual acuity ≥ 20/200 in the better eye were included. Patients with visual acuity < 20/200 in the better eye, history of surgery within last 6 months, previous therapy for glaucoma, history of systemic illness and chronic medical therapy for any illness were excluded from the study. Ocular evaluation included Vision testing, gonioscopy, applanation IOP, stereoscopic evaluation of optic nerve head, and visual field assessment (Humphrey SITA std. 30-2).The glaucoma patients were started on medical therapy and the QoL assessment was repeated after 3 months.
Results: :
Glaucoma patients (mean age: 55.58±9.59 years, range 40 - 77 years) and controls (mean age: 54.90±6.70 years, 42 - 73 years) were matched with respect to age (p = 0.72) and gender (p = 0.91). Glaucoma patients had significantly worse QoL as compare to controls at baseline across all the 3 domains (p < 0.001). At 3 months after treatment the overall QoL life significantly worsened from baseline with a decrease in general functioning (p < 0.001) and psychosocial impact (p = 0.041) domains. In multiple linear regression analysis visual acuity in better eye was significantly related to poor QoL at baseline (p= 0.0001) and at 3 months (p = 0.04), additionally the use of > 2 topical medications was significantly related to poor QoL at 3 months (p= 0.01).
Conclusions: :
Evaluation using the IND-VFQ33 revealed that newly diagnosed patients with primary glaucoma have a significantly worse QoL as compared to healthy controls which further worsens with initial medical therapy. This may affect the compliance and persistence to topical medical therapy in newly diagnosed glaucoma patients and should be an important consideration when educating patients about the disease and its therapy.
Keywords: quality of life