Assessing Quality of life of Patients with Cataract and Glaucoma using Generic and Vision-Specific Instruments in India

Background: The study assesses the 'health-related quality of life' (HRQoL) in patients with cataract and glaucoma, examines its determinants through both generic and vision-specific instruments, and evaluates the degree of agreement between the two HRQoL assessment tools. Methods: A facility-based survey was carried out among 541 participants (297 glaucoma patients and 244 cataract patients) in outpatient settings of tertiary facility from January to June 2024. After obtaining informed consent, the participants were interviewed about their sociodemographic characteristics, medical history, and HRQoL. The mean utility value for the 'EuroQol five dimensions five levels' ('EQ-5D-5L') and the composite score for the 'National Eye Institute Visual Function Questionnaire-25' ('NEI-VFQ-25') were calculated. Factors influencing HRQoL were analyzed through a generalized linear regression model. Additionally, Pearson's correlation coefficient was determined to evaluate the correlation between the HRQoL derived through vision-specific and generic measures. Results: The 'EQ-5D-5L' utility values were 0.74 (0.71-0.77) and 0.87 (0.85-0.89) in glaucoma and cataracts, respectively. The 'NEI-VFQ-25' composite score was 74.8 (72.2-77.2) in glaucoma and 79.3 (77.3-81.2) in cataract. Visual acuity was significantly associated with HRQoL in both disorders. 'NEI-VFQ-25' score had a strong and moderate correlation with EQ-5D-5L value in glaucoma and cataract, respectively. Conclusion: The decrement in HRQoL in patients with glaucoma and cataract underscores the need to prioritize policies for improving awareness, early detection, and management of these diseases. While the 'EQ-5D-5L' adequately captures HRQoL in glaucoma, the incorporation of vision-specific bolt-on dimension to the generic instrument in cataract should be explored.