Health-related quality of life in patients with trachomatous trichiasis or entropion.

PURPOSE: To determine the health-related quality of life in patients with trachomatous trichiasis or entropion, before and after intervention.

METHODS

A prospective, case-control, interventional study. Health-related quality of life was evaluated in 60 patients with trachomatous trichiasis or entropion, before and after intervention, and 60 age- and gender-matched controls without trichiasis or entropion, using the WHOQOL-Bref questionnaire. Thirty patients and controls had vision < 6/18, while 30 had vision = 6/18 in the better eye. The WHOQOL-Bref assesses four domains of quality of life: physical health (1), psychological health (2), social relationships (3), and environment (4). Domain scores of patients and controls and of patients before and after intervention were compared using Student's t-test. Patient characteristics were correlated with domain scores using Pearson's correlation.

RESULTS

Quality of life was poorer than that of controls in domains 1 and 2 for patients with vision < 6/18 in the better eye (p < 0.001, p = 0.001, respectively), and in domains 1, 2 and 4 for patients with vision = 6/18 (p < 0.001, p < 0.001, p = 0.01, respectively). Scores improved after intervention in all domains except domain 3, even though vision did not improve.

CONCLUSIONS

Patients with trachomatous trichiasis or entropion suffer in the physical, psychological and environmental domains of health-related quality of life even when vision is normal. Timely intervention is essential not only to prevent corneal blindness but also to reduce the suffering caused by the non-visual symptoms. Future studies must identify barriers to therapeutic intervention, and attempts should be directed at overcoming them so as to reduce the non-blinding burden of trachoma.