Glaucoma and Quality of Life. The Salisbury Eye Evaluation

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.