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Quality of Life and Functional Vision in Children with Glaucoma
Annegret Dahlmann-Noor1, Vijay Tailor2, Catey Bunce3
1National Institute of Health Research Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology and Moorfields Eye Hospital, London, United Kingdom; Paediatric Service, Moorfields Eye Hospital, London, United Kingdom.
Insights
Glaucoma significantly impairs functional vision and quality of life (QoL) in children. This study found reduced vision-related and health-related QoL in pediatric glaucoma patients.
Area of Science:
- Ophthalmology
- Pediatric Health
- Quality of Life Research
Background:
- Glaucoma is a leading cause of irreversible blindness in children.
- Understanding the impact of pediatric glaucoma on functional vision and quality of life (QoL) is crucial for comprehensive care.
Purpose of the Study:
- To evaluate the effect of glaucoma on functional vision (FVA)
- To assess vision-related (VR) and health-related (HR) quality of life (QoL) in children up to 16 years of age.
Main Methods:
- Cross-sectional observational study involving 119 children (2-16 years) with glaucoma.
- Utilized the Cardiff Visual Ability Questionnaire for Children (CVAQC) for FVA.
- Assessed VR QoL with the Impact of Vision Impairment for Children (IVI-C) and HR QoL with the Pediatric Quality of Life Inventory (PedsQL).
Main Results:
- Children with glaucoma showed reduced scores in FVA, VR QoL, and HR QoL.
- Psychosocial aspects of HR QoL were more affected than physical aspects.
- Older children reported less impairment compared to younger children, and parents reported a greater impact on HR QoL than children.
Conclusions:
- Glaucoma and its management significantly impact a child's functional vision and overall QoL.
- Children with glaucoma experience HR QoL comparable to those with severe chronic conditions like congenital heart defects or leukemia.
Purpose:
To evaluate the effect of glaucoma on functional vision and on vision-related (VR) and health-related (HR) quality of life (QoL) in children up to 16 years of age.
Design:
Cross-sectional observational study.
Participants:
One hundred nineteen children 2 to 16 years of age (mean age, 9.4 years; standard deviation [SD], 4.56 years) with glaucoma and their parents.
Methods:
Completion of 3 validated instruments for children to assess (1) functional visual ability (FVA) with the Cardiff Visual Ability Questionnaire for Children (CVAQC), (2) VR QoL with the Impact of Vision Impairment for Children (IVI-C), and (3) HR QoL with the Pediatric Quality of Life Inventory (PedsQL) version 4.0.
Main Outcome Measures:
Cardiff Visual Ability Questionnaire for Children, IVI-C, and PedsQL scores.
Results:
Scores for FVA, VR QoL, and HR QoL were reduced in children with glaucoma: median CVAQC score, -1.24 (interquartile range [IQR], -2.2 to -0.11; range, -3.00 higher visual ability to +2.80 lower visual ability); mean IVI-C score, 67.3 (SD, 14.4; normal VR QoL, 96); median PedsQL self-report, 78.8 (IQR, 67.4-90.2); parent report, 71.2 (IQR, 55.7-85.8); and family impact score, 74.3 (IQR, 56.9-88.5; normal HR QoL, 100). Psychosocial subscores were lower than physical subscores on the PedsQL. Older children reported less impairment on CVAQC, IVI-C, and PedsQL than younger children. Parents reported greater impact on their child's HR QoL than children reported themselves.
Conclusions:
Glaucoma and its management have a marked impact on a child's FVA and QoL. Children with glaucoma report HR QoL scores similar to those described by children with severe congenital cardiac defects, who have undergone liver transplants, or who have acute lymphoblastic leukemia.