Quality of Life (QoL) in Glaucoma Patients

The interest of clinicians and researchers concerning the quality of life (QoL) assessment in chronic diseases increases constantly. Many definitions have been proposed for the term quality of life, but it is commonly accepted that a universal definition of QoL is rather infeasible to be given. Furthermore, Aaronson has noted the multidimensionality of QoL in terms of physical (symptoms of a disease and treatment), functional (activities of daily living, mobility), social (interpersonal contacts and relationships) and psychological (mental health, emotional balance) parameters that compose it.1 Since the first research efforts that tried to examine QoL in glaucoma2, serious advancement has been accomplished in this field, offering a better understanding of how and to what extend glaucoma influences QoL of individuals suffering from the disease. In addition, glaucoma QoL research yielded important insights with regard to the domains of daily living that are mostly affected by the disease. It is well documented that glaucoma is a leading cause of visual impairment and blindness. Epidemiologic studies demonstrate that 2% of adults over the age of 40 suffer from glaucoma, with the disease prevalence increasing significantly with age.3,4 Vision loss exerts a negative impact on physical ability of patients to perform activities of daily living (reading, adapting to different levels of light, outdoor mobility, avoiding obstacles, etc.), despite maintenance of central visual acuity in less advanced stages of the disease.5 Furthermore, literature suggests that patients with impaired QoL form a more severe burden on health-care resources.6,7 Knowledge and information regarding the QoL of glaucoma patients could be useful in several aspects. It can help ‘decision making’ concerning customized disease management of individuals with glaucoma and promote alterations and guidelines regarding patients’ daily living and safety (i.e. adjustment of home environment), in order to avoid problems concerning adaptation to variable lighting conditions, avoiding obstacles, near activities, outdoor mobility/activities (walking, driving) and other tasks that glaucoma patients seem to give the greatest importance and are significantly correlated with their QoL.8,29 The diagnosis of glaucoma impacts individuals differently, with the majority of cases having little understanding of the need for adherence to their daily therapeutic regimen and the disease natural course and progress.9 Towards this direction, information gained from QoL studies could improve the education of newly diagnosed patients and help them realize the severity of the disease and the importance of the adherence to daily treatment, despite the fact that symptoms are absent in early stages.