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Journal of Ophthalmology
Volume 2017, Article ID 1621640, 7 pages
Research Article

Gradually Then Suddenly? Decline in Vision-Related Quality of Life as Glaucoma Worsens

Division of Optometry and Visual Science, School of Health Sciences, City, University of London, London, UK

Correspondence should be addressed to David P. Crabb;

Received 12 December 2016; Accepted 5 March 2017; Published 2 April 2017

Academic Editor: Antonio M. Fea

Copyright © 2017 Lee Jones et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To evaluate the relationship between self-reported vision-related quality of life (VRQL) and visual field (VF) loss in people from glaucoma clinics. Methods. A postal survey using the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was administered to people with a range of VF loss identified from a UK hospital-based glaucoma service database. Trends were assessed in a composite score from NEI VFQ-25 against better-eye mean deviation (BEMD) using linear regression and a spline-fitting method that can highlight where a monotonic relationship may have different stages. Results. A total of 636 patients (median [interquartile range] BEMD −2.1 [−5.2, −0.4] dB, median age 70 [60, 77] years) were analysed. Analysis of trends in the data revealed an average patient loses approximately 2 units (out of 100) on NEI VFQ-25 for every loss of 1 dB (BEMD) as VF defects first become bilateral, up to BEMD −5 dB. NEI VFQ-25 deterioration then appears to slow before a more rapid phase of change (4–5 units per 1 dB loss) after BEMD worsens beyond −15 dB. Conclusions. Relationship between decline in VRQL and VF worsening in glaucoma is unlikely to be linear; it more likely has different phases, and these should be further explored in longitudinal studies.