Glaucoma and Quality of Life: The Salisbury Eye Evaluation
Received 16 October 2006; received in revised form 28 April 2007; accepted 30 April 2007. published online 28 July 2007.
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.
Available online: July 26, 2007.
Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Reprint requests to Dr David Friedman, Wilmer Eye Institute, Room 120, Johns Hopkins University, 600 North Wolfe Street, Baltimore, MD 21287.
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.
ABSTRACT