Assessing Quality of Life in Glaucoma Patients Using the Glaucoma Quality of Life – 15 (GQL–15) Questionnaire

Abstract

Abstract: : Purpose: Despite an insidious onset without symptoms, patients with open–angle glaucoma (OAG) may experience difficulty with daily activities from its early stage onwards. A new questionnaire, the GQL–15, has been specifically developed to assess quality of life (QoL) in glaucoma patients by measuring severity of visual disability for 5 key activity groups: (i) central and near vision, (ii) peripheral vision, (iii) dark adaptation and glare, (iv) personal care and (v) outdoor mobility. In this study we assessed QoL using the GQL–15 in a cohort of patients with OAG and correlated self–reported visual disability with objective measures of visual function. Methods: Patients with and without OAG attending an urban glaucoma practice and meeting the study’s exclusion criteria were enrolled from May to October 2004. All performed achromatic perimetry using a Humphrey Field Analyser (HFA) prior to completing the GQL–15. Information on glaucoma type, current treatment, visual acuity, HFA mean deviation (MD), HFA pattern standard deviation (PSD) and number of binocular points missed (≤ 20 degrees radius) were collected. Correlation coefficients were calculated using the Spearman’s correlation test. Results: 121 patients with OAG and 31 controls were enrolled. On a scale from 15 (no visual disability) to 75 (severe disability for all visual tasks), the mean GQL–15 summary score was 18.5 for controls and 30.5 for OAG. The GQL–15 summary score was significantly correlated with visual acuity (r=–0.39701, p<0.0001), MD (r=–0.47043, p<0.0001), disease severity (r=0.49278, p<0.0001), and number of binocular points missed (r=0.55821, p<0.0001). GQL–15 summary scores were significantly higher in patients with early (p<0.0019), moderate (p<0.0001) or advanced OAG (p<0.0001) compared to control. Conclusions: By using the GQL–15 questionnaire, we have demonstrated that patients with OAG report a decline in QoL compared to individuals without glaucoma. Reduced QoL in these patients correlates strongly with reduced VA, severity of visual field defects and presence of binocular field defects. Further analysis will reveal whether specific visual functions, such as glare and dark adaptation, are affected preferentially in early, moderate or advanced OAG.

Keywords: quality of life • visual fields • visual acuity