Impact of glaucoma, lens opacities, and cataract surgery on visual functioning and related quality of life: the Barbados Eye Studies

Abstract

Purpose: To determine the relationship of open-angle glaucoma (OAG) and lens opacities to visual functioning and related quality of life (QOL), by using the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) in a population of African origin.

Methods: The study included 962 black participants of the Barbados Eye Studies with known glaucoma, prior cataract surgery, visual acuity (VA) <or=20/200, or self-reported fair to poor vision and consecutive participants without these conditions. Standardized examinations and protocols were used to define OAG and lens opacities. Associations with VFQ scores were evaluated by multiple regression analyses.

Results: After adjustment for age, additional demographic variables, and comorbidities, the presence of OAG was significantly associated with lower scores for distance activities, mental health, and color and peripheral vision, with an overall adjusted mean difference of approximately three points in composite scores. Significantly lower scores were found with PSC opacities, with an overall adjusted mean difference of 6 points (95% CI: 3.3-8.8) for the composite score. Persons who had undergone cataract extraction without intraocular lens implantation reported generally lower scores in many domains than those with pseudophakia and those without cataract surgery, with significantly lower adjusted mean scores for distance activities, social functioning, and color vision.

Conclusions: Inferior vision-related QOL was associated with OAG, PSC, and aphakic cataract surgery, as assessed by the NEI-VFQ-25 in this African-origin population. Findings highlight the importance of targeting public health policy, patient care strategies, and social policy, to assist patients with glaucoma, cataract, and surgical aphakia in better coping with the impact of these conditions on QOL.