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Measuring Disability in Glaucoma

Sotimehin, Ayodeji E., BA*; Ramulu, Pradeep Y., MD, MHS, PhD*,†

doi: 10.1097/IJG.0000000000001068
Review Article

Background: Glaucomatous visual field loss can have far-reaching and debilitating consequences on an individual, affecting one’s ability to perform many important tasks. Although assessment of glaucoma-related disability constitutes an important part of clinical care, there remains a lack of organized, detailed information on the most suitable methods to capture disability in glaucoma.

Purpose: This review details the available methods to measure glaucoma-related disability and highlights important findings from studies utilizing these various methods.

Methods: The literature was reviewed to identify papers evaluating disability in glaucoma and findings were summarized by research methodology used and area of impairment.

Results: Identified methods for capturing glaucoma-related disability included qualitative descriptions, glaucoma-specific quality of life questionnaires, vision-specific questionnaires, general health questionnaires, functional domain-specific questionnaires, evaluation of task performance, event assessment (ie, falls and motor vehicle accidents), and real-world behavior (ie, daily physical activity). Findings using these methods show a strong relationship between glaucoma and/or glaucoma severity and difficulties with reading, driving, mobility, and other tasks such as prehension and facial recognition. In addition, glaucoma has financial and psychological implications on the patient, and can affect caregivers in some cases as well.

Conclusions: A wide variety of research tools have been used to characterize the disability resulting from glaucoma. Together, these tools show that glaucoma affects many abilities which are important for independent living. Strengths and limitations of the various research techniques are discussed so that future studies may use the method(s) most suitable for answering the research question posed.

*The Wilmer Eye Institute, Johns Hopkins University School of Medicine

The Dana Center for Preventive Ophthalmology, Johns Hopkins University; Baltimore, MD

Disclosure: The authors declare no conflict of interest.

Reprints: Pradeep Y. Ramulu, MD, MHS, PhD, 600 N. Wolfe Street, Baltimore, MD 21287 (e-mail:

Received June 25, 2018

Accepted August 18, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.