Vision-Related Quality of Life and Work Productivity in Patients With Keratoconus and Glaucoma: A Comparative Cross-Sectional Study.

BACKGROUND

Keratoconus and primary open-angle glaucoma (POAG) are chronic ocular diseases causing visual impairment and affecting quality of life, daily functioning, and work productivity beyond visual acuity loss. Although both cause chronic visual disability, they differ in pathophysiology, with keratoconus affecting corneal optics and POAG causing progressive optic nerve damage. Comparative evidence regarding their impact on vision-related quality of life (VRQoL) and work productivity remains limited. This study compared patient-reported outcomes between individuals with keratoconus and POAG attending a tertiary ophthalmology center in Greece.

METHODS

In this comparative cross-sectional study, 153 adults (102 with keratoconus and 51 with POAG) completed the National Eye Institute Visual Function Questionnaire-25 (NEI VFQ-25) and the Work Productivity and Activity Impairment Questionnaire (WPAI). Group differences were assessed using independent-samples t-tests or Mann-Whitney U tests, as appropriate. Two-way analysis of variance (ANOVA) examined the effects of demographic and clinical factors on questionnaire outcomes. Statistical significance was defined as p < 0.05.

RESULTS

Patients with keratoconus reported significantly better VRQoL than those with POAG, with higher scores in near and distance activities, peripheral vision, social functioning, driving, color vision, and overall VFQ-25 composite score (all p < 0.05). No significant differences were observed in general vision, ocular pain, or mental health. WPAI scores did not differ significantly between groups, indicating a comparable impact on work productivity. Two-way ANOVA showed that employment status, sex, treatment modality, and comorbidities significantly influenced selected VFQ-25 domains.

CONCLUSIONS

Keratoconus was associated with better VRQoL than POAG, potentially reflecting differences in disease mechanisms and the greater potential for visual rehabilitation through optical correction. Despite these differences, both conditions had a similar impact on work productivity, emphasizing the need to assess functional and socioeconomic outcomes in chronic ophthalmic diseases.