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Editors Selection IGR 11-1

Quality of Life: GQL-15

Comment by Anne Coleman on:

22635 Assessing quality of life in patients with glaucoma using the Glaucoma Quality of Life-15 (GQL-15) questionnaire, Goldberg I; Clement CI; Chiang TH et al., Journal of Glaucoma, 2009; 18: 6-12

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Goldberg et al. (11) offer additional evidence supporting the use of the GQL-15 to assess quality of life in glaucoma patients. Validation of quality of life measures is complicated by the challenge of classifying disease severity by the prospect that awareness of one's disease might affect item responses, and by the determination of an appropriate control group. The broadly consistent findings across two sets of stating criteria are reassuring. Regarding awareness of disease, the patients in the study were aware of their diagnosis; a contrasting perspective can be found in the NEI-VFQ measures obtained by Varma et al. in the Los Angeles Latino Eye Study, where individuals with mild glaucoma were generally unaware of their disease. Control individuals can be challenging to find and recruit, and Dr. Goldberg and colleagues discuss limitations associated with their strategy of recruiting relatives and friends of individuals with ties to the research clinic. It would be interesting to compare different vision quality-of-life instruments on the same patients to judge their relative merits in terms of discriminating across levels of disease severity. The GQL-15 was designed in an effort to provide a metric that is tailored to the concerns of glaucoma patients. Focusing on subscale scores of the GQL-15 may often be useful, in part to distinguish concerns about peripheral vision, which are at the core of the modern concept of glaucoma, and from concerns about glare, which could arise because patients with glaucoma may also have cataracts or intraocular lenses. In summary, the GQL-15 can be used to confirm the association between greater glaucoma severity and worse quality of life. Opportunities for further research include studying the instrument with differently defined control subjects, studying outcomes of individuals who are unaware of their disease, and contrasting alternative vision quality-of-life instruments using the same set of subjects.

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