Which quality of life score is best for glaucoma patients and why?

Methodological quality of the review: Low confidence

Author: Severn P, Fraser S, Finch T, May C

Geographical coverage: United Kingdom (UK)

Sector: Glaucoma

Sub-sector: Quality of life

Equity focus: None specified

Review type: Other review

Quantitative synthesis method: Narrative synthesis

Qualitative synthesis method: Not applicable

Background: Glaucoma affects 2% of the population over 40 years of age and therefore represents a significant public health issue. There have been some attempts to develop quality of life scales for glaucoma. This review discusses the pros and cons of these scales and suggests the best current ones for use in a clinical setting.

Objectives: To narratively highlight the strengths and weaknesses of the available quality of life (QoL) scales and suggest the best one for assessing glaucoma patients in clinical practice.

Main findings: Authors included 11 QoL scales for glaucoma in the review. Based on these, authors noted that there are many tools used for assessment of QoL of glaucoma patients. However, there is no generally accepted ‘best’ tool. Most of the scales are biased towards physical symptoms and do little to address the personal or social factors of the disease.

Authors noted that the NEI-VFQ and NEI-VFQ-25 are the comparative benchmark for QoL tools. The most useful and clinically relevant tool is GQL-15 and the most appropriate research tool is SIG. Further research is required to identify a more precise and user-friendly instrument for use in glaucoma patients. Future research should address personal factors such as worry, self-identity (and the change the disease state makes to this), inconvenience of treatment, financial impact of treatment and alteration in employment/driving.

Methodology: The following databases were searched: MEDLINE, EMBASE and Google Scholar for relevant articles. There was no time limit or type of research. The following keywords used to search were: QoL scores, QoL scales, QoL, eye disease and glaucoma. References of identified articles were checked for any other potentially relevant literature. Authors used a narrative approach to synthesise evidence.

Applicability/external validity: Authors did not discuss the applicability/external validity of the results

Geographic focus: The review focuses on all countries, however studies included were conducted in the UK.

Summary of quality assessment: In this review, authors conducted a narrative synthesis of the finding. However, this review had important limitations: authors did not appropriately report inclusion/exclusion criteria used for study selection, did not report methods used to select studies and to extract data of included studies, nor did they discuss the quality and risk of bias of included studies. Therefore, there is low confidence in the conclusions about the effects of this study.