• glaucoma

Glaucoma is a slow progressive condition that adversely affects quality of life (QoL). According to the European Glaucoma Society, ‘ the goal of glaucoma treatment is to maintain the patient’s visual function and related quality of life, at a sustainable cost’.1 Treatment goals are expected to take patients’ QoL into consideration: ‘Target intraocular pressure (IOP) is the upper limit of the IOP estimated to be compatible with a rate of progression sufficiently slow to maintain vision-related quality of life in the expected lifetime of the patient’.1

Assessment of QoL of people with glaucoma is, therefore, an important goal for clinicians. At least 20 vision-specific patient-reported outcome measures claim to assess QoL in glaucoma, reflecting the importance of this topic.2–6 These measures are summarised in table 1. Despite the plethora of QoL measures that exist, a recent National Institute for Health and Care Excellence (NICE) guideline on glaucoma7 indicated that there is uncertainty about which QoL instrument should be used to evaluate glaucoma interventions, and proposed the identification or development of an appropriate measure of QoL as a research priority. The widely used EuroQoL 5 Dimension Scale (EQ-5D), which is the standard instrument used by NICE for policy making, has been shown to be inappropriate for some vision disorders (leading to a suggestion of EQ-5D bolt-on items for vision disorders).8 In addition, the sensitivity of existing QoL instruments to detect change is uncertain.9 It is important to investigate these knowledge gaps given that treatment goals are linked to QoL in glaucoma. In particular, there is a need to examine the following aspects of existing QoL measures used in glaucoma: (1) content, (2) response and (3) …