title: Impact of glaucoma on visual functioning in Indians.
abstract: OBJECTIVE
  To evaluate the impact of glaucoma on visual functioning in Indians.
  
  
  METHODS
  Patients attending the glaucoma service who had undergone a comprehensive glaucoma evaluation were recruited. Better mean deviation (MD, using Humphrey Field Analyzer program 24-2) between two eyes was used to classify participants into mild, moderate, and severe visual field (VF) loss groups. Participants were administered the Glaucoma Quality of Life-15 (GQL-15) questionnaire. Rasch analysis was used to validate the GQL-15 and its four subscales. Linear regression was used to determine associations between GQL-15 scores and VF loss after adjusting for sociodemographic variables.
  
  
  RESULTS
  A total of 198 patients (mean age ± SD, 59.8 ± 12.3 years; 67% male) were recruited. Participants with severe VF loss (39%) followed by mild loss (35%) comprised the largest group. Rasch analysis resulted in a 10-item reliable and valid questionnaire: the Glaucoma Activity Limitation-10 (GAL-10). Although a single subscale, "peripheral vision," met requirements of the Rasch model, it could not be preserved in the GAL-10. In multivariate analyses, the middle-income group (compared with higher income) and severe VF-loss (compared with mild VF-loss) participants reported significantly poorer functioning on GAL-10 ([β = 0.84; 95% confidence interval (CI), 0.16-1.52; P = 0.02] and [β = 1.19; 95% CI, 0.61-1.78; P < 0.000], respectively). None of these associations were, however, clinically significant.
  
  
  CONCLUSIONS
  Glaucoma patients in India, especially those with severe VF loss, face significant challenges in performing daily tasks and in mobility. It is important to prevent progression such that activity limitation is minimized in glaucoma patients.
authors.affiliation: Meera and L B Deshpande Centre for Sight Enhancement, Vision Rehabilitation Centres, Hyderabad, India. vijayagothwal@gmail.com
authors.forename: Vijaya K
authors.initials: VK
authors.lastname: Gothwal
authors.forename: Shailaja P
authors.initials: SP
authors.lastname: Reddy
authors.forename: Seelam
authors.initials: S
authors.lastname: Bharani
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Bagga
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sumalini
authors.forename: Chandra S
authors.initials: CS
authors.lastname: Garudadri
authors.forename: Harsha L
authors.initials: HL
authors.lastname: Rao
authors.forename: Sirisha
authors.initials: S
authors.lastname: Senthil
authors.forename: Vanita
authors.initials: V
authors.lastname: Pathak-Ray
authors.forename: Anil K
authors.initials: AK
authors.lastname: Mandal
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014792:Visual Acuity / Q000502:physiology*; D014794:Visual Fields / Q000502:physiology