LAUSR

PURPOSE To develop a vision-targeted health-related quality-of-life (HRQoL) instrument for patients with glaucoma who are candidates for minimally invasive glaucoma surgery (MIGS). DESIGN Development of a health-related quality-of-life instrument. PARTICIPANTS Twelve practicing ophthalmologists and 41 glaucoma patients. METHODS A questionnaire was constructed to assess functional limitations, vision-related symptoms, aesthetics, psychosocial issues, and surgical satisfaction for MIGS candidates. Questions were drafted following a review of the literature, and subsequently refined based upon input from one physician and four patient focus groups. Nineteen cognitive interviews were used to ensure questions were understandable to respondents. RESULTS The focus group identified the following key issues and concerns as being important to glaucoma patients: functional limitations (e.g. driving), bodily discomfort (e.g. stinging from drops), changes in appearance (e.g. drooping eyelid), and psychosocial concerns (e.g. burden associated with a diagnosis of glaucoma, financial burden of treatment). Cognitive interviews resulted in the following improvements to the questionnaire: changes in wording to clarify lighting conditions, additional questions addressing psychosocial issues such as job loss, severity of disease, and perception of MIGS. CONCLUSIONS A patient-reported outcome (PRO) instrument, the Glaucoma Outcomes Survey (GOS), was developed to evaluate MIGS for patients with mild to moderate glaucoma. Next steps include electronic administration to patients selected from the American Academy of Ophthalmology IRIS registry. An electronic patient-reported outcome (ePRO) platform will be used to administer the questionnaire before and after MIGS. The questionnaire will improve understanding of how surgical interventions such as MIGS impact VRQoL in patients with mild to moderate glaucoma.