Study finds that even mild disease affects glaucoma patients' quality of life

HONG KONG — While glaucoma patients with mild disease often do not complain of visual loss and appear to be asymptomatic, an analysis of questionnaire results showed their quality of life is significantly reduced compared with nonglaucomatous controls. The prospective cross-sectional study looked at quality of life responses from 121 open-angle glaucoma patients and 31 nonglaucomatous patients in a control group, according to Ivan Goldberg, MBBS, FRANZCO, FRACS. He spoke at the World Ophthalmology Congress meeting here about the study, which he conducted with colleagues.

Ivan Goldberg

"Patients with mild glaucoma appear to be asymptomatic and may not report vision-related difficulty, but compared with controls, even they experience significant reductions in quality of life," Dr. Goldberg said.

He said the study showed that early diagnosis and treatment are crucial to improving patients' quality of life in all stages of the disease. Visual loss from glaucoma progression is often portrayed as occurring suddenly, he said, similar to "falling over a ledge" in visual ability. The reality might be closer to a gradual loss, progressing steadily over time from onset of the disease, he said. That finding would render early diagnosis and treatment especially important.

Asking patients to fill out the quality-of-life questionnaire could help physicians monitor patients' progression from mild to later stages of the disease, he said.

"We should think about administering a simple questionnaire like the Glaucoma Quality of Life questionnaire, which is freely available, so that we actually have the information about which patients are already having problems," he said.

In the study, glaucoma patients in different stages of disease severity answered a condensed version of the Glaucoma Quality of Life 15 questionnaire developed by Patricia Nelson, PhD, and colleagues. The study divided patients into three groups according to disease severity: 49 patients with mild glaucoma, 34 with moderate and 38 with severe.

After patients responded to the questionnaire, Dr. Goldberg and colleagues scored for four subscale factors. Those subscale factors assessed central and near vision issues, such as reading and recognizing faces; tasks affected by peripheral vision, such as walking on uneven ground and steps; dark adaptation and glare, such as seeing at night; and outdoor mobility, such as crossing the road, according to Dr. Goldberg.

Patients with all stages of glaucomatous progression had difficulty with those tasks, he said, showing that quality of life significantly decreased with progression of the disease, as well as in early stages.