The impact of treatment modality on quality of life in glaucoma patients: findings from a clinical survey study in Augusta, GA

Abstract

Purpose: This study evaluates the impact of medical versus combined medical and surgical glaucoma treatments on patients’ quality of life (QoL). While both approaches reduce intraocular pressure, research shows mixed effects on QoL. Given updated clinical guidelines and the gap in QoL-focused glaucoma management, this study applies validated QoL measures to assess treatment effects and inform patient-centered care. Methods: From June to October 2023, 180 patients at Augusta University Eye Care Center completed the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and Glaucoma Profile Instrument (GPI) surveys. Chart reviews provided demographic and clinical data, including glaucoma status and treatment. QoL scores were calculated using validated algorithms. Associations between clinical variables and QoL outcomes were analyzed using ANOVA and t-tests in R 4.4.1. Results: Among 180 patients, 103 had glaucoma or were suspects. 64% of glaucoma patients received medical treatment only, and 34% received combined medical and surgical treatment. VFQ-25 scores differed significantly by race (p = 0.0489), severity (p = 0.0001), and age (p = 0.0459), but not by gender, glaucoma status, or treatment. Severe glaucoma patients had the lowest QoL. Severity strongly impacted GPI scores (p = 0.0092) and multiple VFQ-25 domains. Differences by treatment modality were observed only in the driving subscale (p = 0.0378). No significant differences were observed in overall QoL scores between treatment groups. Conclusion: No significant vision-related QoL differences were found between treatment groups. Most patients were medically managed, possibly reflecting limited QoL benefit from surgery. QoL correlated more with disease severity than treatment modality or demographics. These findings highlight a disconnect between current treatment strategies and patient-perceived outcomes, underscoring the need for innovative strategies to improve QoL in glaucoma care.