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P. Channa, N. Priyev, A. Madu; Visual Function and Quality of Life in Glaucoma Patients in a South Bronx Clinic. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1111.
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Clinicians need to understand the vision-related Quality of Life (QOL) ramifications of their patients. A correlation between objective clinical measures of Visual Function in glaucoma patients and results of QOL surveys, especially the Glaucoma Quality of Life Questionnaire-15 (GQL), has been demonstrated in a number of studies. We assess if this British-developed survey has utility in an eye clinic where the majority of patients are Hispanic or African American by exploring any correlation between the severity of a patient’s Mean Deviation (MD) and their responses to the survey. Furthermore, we assess if higher MDs and worse GQL scores correlate with a higher incidence of patients’ actually asking for specific assistance, with the aim of helping ophthalmologists predict the need for referral to Low-Vision Assistance Organizations (LVAO).
The range of GQL scores: 15 (no visual disability) to 75 (severe visual disability). Also, 5 "Yes" or "No" questions were added asking patients if they need low-vision assistance such as a safety training on how to navigate the bus and subway, job training for people with low vision, talking watch, books on tape, large print books, and emotional support for vision loss. 23 patients/45 eyes were included.
The results were separated into 2 groups: those with a GQL score of 15 through 29 (Group 1), and those with a score of 30 and above (Group 2), where the difference in the scores is significant (p<0.0001). The ages of the samples in Groups 1 (66.8±9.53) and 2 (66.6±11.32) were not statistically different (p=0.2000; CI: -6.27 to +6.67). The average MD was found to be significantly lower among patients in Group 1 (5.37±5.25) than in Group 2 (14.76±9.22 ) (p<0.0001 CI: -13.7 to -5.05). The number of positive responses to questions that ask if patients need help because of visual deficits was also significantly lower in Group 1 than 2 (p<0.0003).
Because of the strong correlation of higher MD with worse GQL scores, it appears that the survey has utility in our patient population. Though the enrolled patients do not fit the criteria for legal blindness, many patients, especially those with higher MDs (and GQL scores), reported significant difficulties with Activities of Daily Living (due specifically to poor vision) through their responses to the questionnaire, and explicitly requested the type of assistance typically provided by LVAOs. Clinicians need to be aware that there is a multitude of such patients, and that patients need to be asked if such help is needed even if they are not legally blind.
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