Health-Related Quality of Life in Adult Patients With Glaucoma, With or Without Visual Impairment in the US: Analysis of National Data From 2017 to 2021

OBJECTIVES: Glaucoma is a cluster of eye conditions that can lead to visual impairment and vision loss due to damage to the optical nerve. Both disease and its management can significantly affect a patient’s health-related quality of life (HRQoL). This study aims to compare the HRQoL of adult glaucoma patients with and without visual impairment.

METHODS: This retrospective, cross-sectional study included adults diagnosed with glaucoma from the 2017-2021 Medical Expenditure Panel Survey (MEPS). Adults (≥ 18 years) with glaucoma were identified using the International Classification of Diseases (ICD-10) codes. The visual impairment variable measured serious difficulty in seeing even with glasses (Yes/No). The HRQoL was evaluated using Physical Component Summary (PCS) and Mental Component Summary (MCS) scores based on the Short Form Health Survey (SF-12). Linear regression was used to measure the association of visual impairment with HRQoL, adjusting for covariates based on the conceptual framework of the Wilson and Clary model. The Elixhauser comorbidity index score was used to control for other comorbid conditions.

RESULTS: An estimated 4.88 million (95% CI: 1.39-1.62) adults annually had glaucoma. Most of the glaucoma patients were female (57.59%), between 65-74 years of age (31.69%), and non-Hispanic Whites (67.65%). Among the glaucoma patients, 10.77% (95% CI: 9.15 – 12.38) had visual impairment. After adjusting for individual characteristics, glaucoma patients with visual impairment had 9.91 (95% CI: 8.01-11.80) units lower PCS scores than those without visual impairment. The MCS scores were 6.05 (95% CI: 4.10 – 9.00) units lower among those with visual impairment than those without.

CONCLUSIONS: Visual impairment is a major determinant of HRQoL in persons with glaucoma. Our findings suggest that not only the physical aspects of HRQoL are affected, but also mental aspects due to visual impairment. More work is needed to understand the role of treatment and surgeries to mitigate glaucoma and improve HRQoL.