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PURPOSE: To understand the impact of glaucoma on ability to function and on quality of life to guide therapeutic choices and strategies for improved adherence to therapeutic regimens and to suggest alterations to environments to help the patient to cope better with the effects of the disease. DESIGN: Review of the published literature on quality-of-life assessments of patients with glaucoma. METHODS: The published literature on quality-of-life impacts of glaucoma was reviewed with a focus on the design and evolution of quality-of-life instruments, correlations of responses with objective measures of disease progression, and insights that were gained from the analyses of results. RESULTS: Information about the impact of glaucoma has been derived from responses to general health-related questionnaires, vision-specific questionnaires, and questionnaires that were designed to be glaucoma specific. Responses to glaucoma-specific instruments tend to correlate best with visual field measurements and other objective measures of disease progression, which suggests that such responses reflect the effects of glaucoma rather than the effects of other health-related issues in this patient population. Recent advances in the design of glaucoma-specific instruments and in analysis of the responses to them have provided some interesting insights. For example, patients who have experienced significant (peripheral) visual field loss attach greater importance to their central vision than do patients with less-advanced disease, but these patients seem to have accepted or adapted to their difficulties with outdoor mobility. CONCLUSION: Continued improvements in the collection and analysis of quality-of-life data should assist health care providers with the effective delivery of therapies to patients with glaucoma.
Dr. G. Spaeth, Wills Eye Hospital, Philadelphia, PA 19107, USA. gspaeth@willseye.org
1.4 Quality of life (Part of: 1 General aspects)