Mental Health and Quality of Life in Glaucoma Patients: Insights From a Comparative Study

青光眼患者的心理健康和生活质量:一项比较研究的启示

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Abstract

Introduction Glaucoma, a chronic and progressive optic neuropathy, is a leading cause of irreversible blindness, affecting both visual function and quality of life (QoL). The disease's progression, alongside the fear of blindness, contributes to anxiety, depression, and reduced life satisfaction. This study aimed to evaluate the impact of glaucoma on mental health and QoL and to examine the relationship between glaucoma severity and psychological and functional factors. Methods A cross-sectional study was conducted involving 102 patients with glaucoma and 82 age-matched controls without significant ocular disease. All participants completed the 12-Item Short-Form Health Survey version 2 (SF-12v2) to assess general health and the Glaucoma QoL Questionnaire (Glau-QoL-17) for disease-specific QoL. Additional demographic and clinical data, such as education level, household composition, driving status, type of glaucoma, best-corrected visual acuity, number of antiglaucoma medications, static automated perimetry results, psychiatric comorbidities, use of psychiatric medications, and disease-related anxiety were also recorded. Results Glaucoma patients had a mean age of 72.3 ± 7.6 years, with 52.0% (n=53) being female, compared to a mean age of 70.1 ± 18.2 years in the control group, with a female population of 51.2% (n=49). Glaucoma patients scored significantly lower in general health compared to controls (Physical component score: 41.3 ± 11.3 vs. 49.7 ± 8.3 (p < 0.001); Mental component score: 41.8 ± 10.8 vs. 51.0 ± 9.2 (p < 0.001), affecting physical functioning, vitality, social functioning, and mental health. Disease-specific QoL was also worse in glaucoma patients (Glau-QoL-17 total score: 44 vs. 58, p < 0.001), particularly in anxiety, self-image, daily life activities, psychological state, constraints, and self-care. Psychiatric comorbidities were more frequent in glaucoma patients (46.1% vs. 22%) (p < 0.001), with 64.7% (n=66) reporting disease-related anxiety. Significant correlations were found between visual field loss severity and both physical (p = 0.028) and emotional (p = 0.035) role functioning, as well as general health perception (p = 0.015). Conclusion Glaucoma significantly impacts both general and disease-specific QoL, with more severe visual field impairment associated with poorer physical health outcomes. The high prevalence of psychiatric comorbidities and increased use of psychiatric medications further illustrate the psychological burden of glaucoma. These findings highlight the need for holistic care approaches that address both the physical and mental health aspects of glaucoma management.

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