Visual impairment, visual functioning, and quality of life assessments in patients with glaucoma

Background/Purpose: To determine the relation between visual impairment, visual functioning, and the global quality of life in patients with glaucoma. Methods: Visual impairment, defined with the American Medical Association Guides to the Evaluation of Permanent Impairment; visual functioning measured with the VF-14 and the Field Test Version of the National Eye Institute - Visual Functioning Questionnaire (NEI-VFQ); and the global quality of life, assessed with the Medical Outcomes Study 36 - Item Short Form Health Survey (SF-36), were determined in 147 consecutive patients with glaucoma. Results: None of the SF-36 domains demonstrated more than a weak correlation with visual impairment. The VF-14 scores were moderately correlated with visual impairment. Of the twelve NEI-VFQ scales, distance activities and vision specific dependency were moderately correlated with visual impairment. Of the twelve NEI-VFQ scales, distance activities and vision specific dependency were moderately correlated with visual field impairment; vision specific social functioning, near activities, vision specific role difficulties, general vision, vision specific mental health, color vision and driving were modestly correlated; visual pain was weakly correlated; and two were not significantly correlated. Correcting for visual acuity weakened the strength of the correlation coefficients. Conclusions: The SF-36 is unlikely to be useful in determining visual impairment in patients with glaucoma. Based on the moderate correlation between visual field impairment and the VF-14 score, this questionnaire may be generalizable to patients with glaucoma. Several of the NEI-VFQ scales correlate with visual field impairment scores in patients with a wide range of glaucomatous damage.