title: Cataract and quality of life in patients with glaucoma.
abstract: BACKGROUND
  To assess the impact of cataract on quality of life (QoL) for patients with glaucoma.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Two hundred forty-two patients with mild (n = 67), moderate (n = 80) or severe (n = 45) glaucoma and 50 controls (glaucoma suspects). Patients with cataract of any severity were included.
  
  
  METHODS
  The following data were collected: sociodemographic information, phakic/pseudophakic status, cataract grade according to the Lens Opacities Classification System (LOCS) III, visual acuity and visual field test parameters. Glaucoma severity was stratified according to binocular visual field loss. Visually significant cataract was defined as: LOCS III criteria nuclear cataract ≥3/6.9, cortical cataract ≥3/5.9 or posterior subcapsular cataract ≥2/5.9.
  
  
  METHODS
  Patients' QoL was measured using Rasch-transformed scores from the Glaucoma Activity Limitation-9 (GAL-9) questionnaire. Multiple linear regression models were used to determine the association between cataract and GAL-9 (logit) score.
  
  
  RESULTS
  Fifty-six (23.1%) patients had at least one visually significant cataract. At least one visually significant cataract (standardized coefficient [β] 1.19, 95% confidence interval 1.04-1.34, P = 0.011) and poor visual field index (better eye) (β 1.47, 95% confidence interval 1.36-1.88, P < 0.001) were independently associated with worse GAL-9 score.
  
  
  CONCLUSIONS
  Cataract influences glaucoma-related QoL among glaucoma patients of all severity levels and is an important cause of potentially reversible visual impairment among glaucoma patients. The Rasch-analysed GAL-9 questionnaire is a useful metric to quantify visual disability related to cataract in glaucoma patients.
authors.affiliation: Discipline of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia.|Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia.|Department of Ophthalmology, Addenbrooke's Hospital, Cambridge, UK.|Departments of Ophthalmology and Surgery, Royal Melbourne Hospital, University of Melbourne.
authors.forename: Simon E
authors.initials: SE
authors.lastname: Skalicky
authors.affiliation: Department of Ophthalmology, Addenbrooke's Hospital, Cambridge, UK.|Cambridge NIHR Biomedical Research Centre, University of Cambridge, Cambridge, UK.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Martin
authors.affiliation: Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Eva
authors.initials: E
authors.lastname: Fenwick
authors.affiliation: Centre for Eye Research Australia, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Jonathan G
authors.initials: JG
authors.lastname: Crowston
authors.affiliation: Discipline of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia.|Eye Associates, Sydney, New South Wales, Australia.|Sydney Eye Hospital, Sydney, New South Wales, Australia.
authors.forename: Ivan
authors.initials: I
authors.lastname: Goldberg
authors.affiliation: Discipline of Ophthalmology, University of Sydney, Sydney, New South Wales, Australia.|Sydney Eye Hospital, Sydney, New South Wales, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: McCluskey
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000503:physiopathology / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005902:Glaucoma, Open-Angle / Q000145:classification / Q000503:physiopathology / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000503:physiopathology / Q000523:psychology*; D014792:Visual Acuity / Q000502:physiology; D058609:Visual Field Tests; D014794:Visual Fields / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000523:psychology*
keywords: Rasch analysis; cataract; glaucoma; quality of life