A New Symptom Survey and Quality of Life Questionnaire for Nasolacrimal Duct Obstruction

Abstract

Abstract: : Purpose: Few established outcome measures exist for studies of nasolacrimal duct obstruction (NLDO) in children. We developed a parental questionnaire directed at NLDO symptoms and health related quality of life (HRQL). The questions were based on expert opinion and parental interviews. Methods: Thirty–four children with NLDO and 22 children without NLDO, ages 6 to <48 months, were enrolled at 9 sites. The examining physician recorded any clinical signs of tearing, discharge, or increased tear lake. A parent then completed an 18–item symptom survey for each eye, and a 10–item HRQL questionnaire. Scores were scaled from 0 to 4, on a 5–point Likert–type scale (i.e., always, often, sometimes, rarely, never). For a by–child analysis, the right eye of each child was used unless the left eye was the only eye with clinical signs. For patients with unilateral signs of NLDO, the scores were compared between eyes. Results: Seventeen of 18 symptom survey questions and 8 of 10 HRQL questions elicited the entire range of possible responses. The symptom score was higher among NLDO patients than the non–NLDO patients (2.68 + 0.73 vs. 0.51 + 0.50, p<0.0001, ranges 0.78 to 3.67 vs. 0 to 1.83). Similarly, the HRQL score was worse among NLDO patients than non–NLDO patients (1.60 + 0.76 vs. 0.88 + 0.66, p=0.0006, ranges 0.10 to 3.20 vs. 0.10 to 2.20). Among 21 children with unilateral NLDO, the affected eye had a higher symptom score than the unaffected eye (2.80 + 0.52 vs. 0.45 + 0.58, p<0.0001). Conclusions: Our NLDO symptom survey and HRQL questionnaire appear useful in assessing NLDO in children. Further studies are needed to determine whether these instruments can reliably assess severity of NLDO and whether they are responsive to successful intervention. If so, the instruments will be useful outcome measures in future clinical studies.

Keywords: quality of life • clinical (human) or epidemiologic studies: outcomes/complications • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled