Conclusions: In addition to standard automated perimetry tests, contrast sensitivity (CS) testing and macular analyses may predict changes in the quality of life (QOL) in patients at different stages of glaucoma.

Objective: To examine the relationship between functional and structural tests of visual function and the 25-item National Eye Institute-Visual Function Questionnaire (NEI-VFQ-25) and the 36-item Short Form (SF-36) Health Survey in patients with different stages of glaucoma.

Methods: Standard automated perimetry tests, optical coherence tomography scans, and CS testing were prospectively performed in 160 patients with glaucoma. The Hoddap-Parrish-Anderson staging system was used for glaucoma staging. Health-related QOL questionnaires (NEI-VFQ-25, SF-36) were also administered to all patients.

Results: The study group comprised 29 patients with suspected glaucoma, 104 with mild glaucoma, 15 with moderate glaucoma, and 12 with severe glaucoma. The mean total score of the NEI-VFQ-25 was 88.8 ± 8.2. The SF-36 did not show a significant correlation with the data on functional and structural tests of visual function, whereas the NEI-VFQ-25 showed a low to moderate correlation ( r = 0.212 to -0.492). Vision parameters can explain up to 18.6% of the total score of the NEI-VFQ-25. CS was the only function significantly correlated with glaucoma suspects, whereas, in the early stages, visual acuity was the strongest correlated function with the NEI-VFQ-25 total score ( P = 0.003 and r = 0.551; P = 0.001 and r = 0.343, respectively). The impact of the visual field on vision-related QOL increased in the advanced stages ( P = 0.013, r = 0.688). The macular retinal ganglion cell plus inner plexiform layer thickness remained associated with NEI-VFQ-25 at all stages of glaucoma ( r = 0.335 to 0.802). The NEI-VFQ-25 total score and most of the subscales were correlated with the physical and mental component summary scores of the SF-36 ( r = 0.159 to 0.587).

Conclusions: Visual acuity correlated the most with QOL in patients with glaucoma, as measured with the NEI-VFQ-25 to assess QOL in glaucoma. The impact of visual functions on QOL varies at different stages of glaucoma.