Beyond Intraocular Pressure: Visual Functioning and Quality of Life in Primary Congenital Glaucoma and Secondary Childhood Glaucoma.

PURPOSE: To compare the visual functioning (VF) and vision-related QoL (VRQoL) of children 8-18 years old treated for primary congenital glaucoma (PCG) and secondary childhood glaucoma. DESIGN: Cross-sectional study. METHODS: A total of 309 children 8-18 years old treated for PCG and secondary childhood glaucoma between 2000 and 2010 by a single pediatric glaucoma specialist were prospectively enrolled at LV Prasad Eye Institute, Hyderabad, India. Children completed 2 questionnaires, the LV Prasad Functional Vision Questionnaire-II (LVP-FVQ-II), and the Impact of Vision Impairment-Children (IVI-C) questionnaire. Rasch-calibrated scores from both these questionnaires were used to compare the VF and VFQoL between the 2 groups. RESULTS: Mean ages of the children were 12.2 and 12.6 years in the PCG (53%, median age at diagnosis = 5 months) and secondary glaucoma groups (47%, median age at diagnosis = 3 years), respectively. A majority (80%) of children had bilateral glaucoma and underwent filtering surgery (83%). Mean better eye logMAR visual acuity (VA) was comparable between PCG and secondary childhood glaucoma groups (0.49 vs 0.52, respectively; P = 0.59). Children with PCG reported significantly better VF and VRQoL than secondary childhood glaucoma patients. Unadjusted and adjusted childhood glaucoma group comparisons revealed secondary childhood glaucoma to be associated with worse VF and VRQoL compared to PCG (difference for VF, -0.83; 95% confidence interval [CI], -1.34 to 0.31; P = 0.002; 0.39; 95% CI, 0.16-0.62; P = 0.001 for VRQoL). CONCLUSIONS: Results show that children with treated PCG experience significantly better VF and VRQoL than those with secondary childhood glaucoma, despite comparable VA and IOP.

Quality of Life of Caregivers of Children With Glaucoma in an Arab Population: A Cross-Sectional Study.

BACKGROUND: To evaluate the quality of life (QoL) measures of caregivers of children with glaucoma using the Caregiver's Congenital Glaucoma Quality of Life (CarCGQoL) questionnaire. MATERIALS AND METHODS: This was a cross-sectional study undertaken at King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. QoL of the caregivers, the main outcome, was assessed using the 20-item CarCGQoL questionnaire. Raw QoL scores of caregivers were converted to Rasch-calibrated interval level scores. A multiple linear regression analysis was performed to identify factors associated with caregivers' QoL. RESULTS: Eighty-five caregivers (46 fathers and 39 mothers) aged 42.5±7.5 years were included in the study. The mean QoL score of caregivers was 0.63 (±1.05). The presence of additional children with glaucoma in the household had the strongest negative relationship with caregivers' QoL [ß=-0.75, 95% confidence interval (CI): -1.22, -0.27; P=0.003]. A poor QoL was noted with mother caregivers (ß=-0.46, 95% CI: -0.87, -0.04; P=0.031) and those caring for blind children (vision <20/200 in the better eye) (ß=-0.52, 95% CI: -0.98,-0.05; P=0.030) when compared with their reference groups. A 22.3% variance in the QoL score was explained by these three factors (adjusted R=0.223). CONCLUSIONS: The QoL of caregivers of children with glaucoma was poor. Caregiver's relation to patients, additional children with glaucoma in the family and patient's vision in the better eye could influence a caregiver's QoL. Periodic evaluation of QoL of caregivers is recommended to plan counseling and other support services.

Functional Visual Ability and Quality of Life in Children With Glaucoma.

PURPOSE: To evaluate the effect of glaucoma and its management on the functional visual ability (FVA) and the vision-related quality of life (VR QoL) in children 8-18 years of age. DESIGN: Cross-sectional study. METHODS: FVA was assessed using the Cardiff Visual Ability Questionnaire for Children (CVAQC) and VR QoL was assessed using the Impact of Vision Impairment for Children (IVI_C) tool. RESULTS: Eighty-five children 8-18 years of age were interviewed at King Khaled Eye Specialist Hospital (KKESH), Riyadh, Saudi Arabia. Scores for FVA and VR QoL were decreased in children with glaucoma: median of CVAQC scores, -0.68 (interquartile range [IQR], -1.27 to 0.19; range, -3.00 higher visual ability to +2.80 lower visual ability); IVI_C mean score, 55.3 (standard deviation, 13.0; normal VR QoL, 96). Factors associated with significantly lower FVA and VR QoL included, lower best-corrected visual acuity (BCVA) (P < .0001 for both FVA and VR QoL), bilateral glaucoma (P = .04 for in FVA and P = .009 in VR QoL), and 3 or more glaucoma surgeries (P < .001 for both FVA and VR QoL). CONCLUSION: FVA and VR QoL as perceived by children with glaucoma are reduced. Children with lower BCVA, those with bilateral glaucoma, and those who had undergone 3 or more glaucoma surgeries had significantly lower FVA and VR QoL. Improving the QoL with psychosocial involvement and visual rehabilitation by the use of low-vision aids among children with glaucoma should be included in the treatment plan in addition to medical and surgical treatment.