Elsevier

Ophthalmology

Volume 115, Issue 2, February 2008, Pages 233-238
Ophthalmology

Original article
Glaucoma and Quality of Life: The Salisbury Eye Evaluation

https://doi.org/10.1016/j.ophtha.2007.04.050Get rights and content

Purpose

To examine whether glaucoma status or measures of visual function affected by glaucoma are associated with self-reported difficulty with vision-intensive tasks in a population-based study.

Design

Cross-sectional study.

Participants

One thousand one hundred sixty individuals who participated in the fourth round of the Salisbury Eye Evaluation study and who did not have visual acuity worse than 20/40 due to a primary cause other than glaucoma.

Methods

Glaucoma was assessed using optic nerve head appearance, visual field (VF) testing, gonioscopy, and physician opinion. Vision-related quality of life was assessed using the Activities of Daily Vision Scale (ADVS), whose scores were trichotomized into the following categories: the least difficulty with visual tasks, some difficulty, and the most difficulty. Data on confounders were collected by questionnaire and clinical examination. Multinomial logistic regression was used to adjust for demographic and health factors.

Main Outcome Measure

Reported difficulty on the ADVS.

Results

Individuals with bilateral glaucoma were more likely to report the most difficulty on the ADVS than those without glaucoma (odds ratio [OR], 3.25; 95% confidence interval [CI], 1.56–6.76), whereas those with unilateral glaucoma were not more likely to report the most difficulty (OR, 1.05; 95% CI, 0.38–2.91). Worse binocular VF scores were associated with increased odds of the most difficulty on the ADVS after adjusting for acuity and contrast sensitivity (OR, 1.48; 95% CI, 1.29–1.85).

Conclusions

Individuals with bilateral glaucoma reported more difficulty on the ADVS than those without glaucoma. This finding, in conjunction with findings demonstrating decreased mobility in patients with bilateral glaucoma, points to the fact that glaucoma affects the report of difficulty with a variety of visual tasks.

Section snippets

Materials and Methods

Data for this analysis came from the Salisbury Eye Evaluation Project, a prospective cohort study of 2520 community-dwelling adults begun in 1993 to study the impact of visual function on physical function.16 Approval from the Johns Hopkins University Joint Committee on Clinical Investigation was obtained. Written informed consent was obtained for all participants.

Eligibility criteria at baseline included age between 65 and 84 years; residence near Salisbury, Maryland; noninstitutionalization;

Results

In the 1160 individuals eligible for this analysis, an evaluation of glaucoma was able to be performed in 1118. There were 67 (5.8%) individuals with bilateral glaucoma, 69 (5.9%) with unilateral glaucoma, and 982 (84.7%) with possible or no glaucoma. Individuals with bilateral glaucoma were older and, after age adjustment, were more likely to be African American and to have less formal education and worse scores for cognition, mean deviation (MD), binocular VF, VA, and contrast sensitivity

Discussion

Individuals with bilateral glaucoma had 3 times the odds of reporting the most difficulty on the ADVS quality of life questionnaire than those without glaucoma, whereas those with unilateral glaucoma were no more likely than those without glaucoma to report the most difficulty on the ADVS. The average VF loss for those with unilateral glaucoma was apparently not severe enough to affect the report of difficulty with visual tasks (average MD in worse eye, −6.5 dB). Those with bilateral glaucoma

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    Manuscript no. 2006-1177.

    Funded by grants from the National Institute on Aging, Bethesda, Maryland (no. AG10184), and National Eye Institute, Bethesda, Maryland (no. EY01765).

    1

    Dr West is a Research to Prevent Blindness (New York, New York) Senior Scientific Investigator.

    2

    Dr Friedman is a Robert E. McCormick Scholar for Research to Prevent Blindness.

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