Functional Status and Well-Being in Patients with Glaucoma as Measured by the Medical Outcomes Study Short Form-36 Questionnaire M. Roy Wilson, MD, MS, 1,2 Anne L. Coleman, MD, PhD, 1 Fei Yu, MS, 1 Eric G. Bing, MD, MPH, 2 Irene Fong Sasaki, MD, 1 Kerry Berlin, BA, 1 John Winters, BS, 1 Alex Lai, BS 1 Purpose: This study aimed to determine whether patients with glaucoma have different functional status and well-being than patients without glaucoma. Design: Prospective case– control study. Participants: The study population was recruited from 2 university-based glaucoma clinical practices and a university-based general ophthalmology clinic and consisted of 121 patients with open-angle glaucoma, 42 with diagnosis of glaucoma suspect, and 135 with no chronic ocular conditions except cataract. Intervention: Administration of Medical Outcomes Study 36-item short-form survey (SF-36) was performed. Demographic information, medical history, and responses to the SF-36 questionnaire were elicited by an interviewer. Medical record review was performed to obtain clinical examination data and to substantiate the medical and demographic data obtained by the interviewer. Main Outcome Measures: The SF-36 scores by diagnostic group, demographic characteristics, and medical history were examined. Secondary outcome measures were SF-36 scores in patients with glaucoma by visual field impairment and glaucoma medication use. Results: Patients with glaucoma consistently had lower scores, control subjects had higher scores, and glaucoma suspects had scores intermediate between the two groups. After adjusting for the possible influence of all the other covariate factors, glaucoma was found to be a strong predictor of lower SF-36 scores. Conclusion: Patients with glaucoma have lower scores, indicating less-functional status, than patients without glaucoma as tested by the SF-36 survey questionnaire. Ophthalmology 1998;105:2112–2116 Clinical measures are familiar to physicians and have proved useful for diagnosing and staging the severity of organ dysfunction and for managing specific treatments. However, it is becoming increasingly accepted that clinical conditions should also be evaluated in terms of their impact on patient functioning and well-being in addition to tradi- tionally defined medical endpoints. Health status and qual- ity-of-life measures have recently emerged as important adjuncts to clinical investigation and patient care. The Med- ical Outcomes Short Form-36 (SF-36) has been studied extensively and has been shown to be a reliable, valid, and statistically proven measure of functional status, well-being, and general health perception. 1–5 Assessments of overall health status and functioning have been performed in patients with a number of chronic diseases. 6 –18 Such assessments have been limited in oph- thalmology and have focused mainly on evaluating func- tional outcomes of cataract surgery. 19,20 Lower functional status and quality of life have been shown to be associated with blurred vision. 21 Our study was designed to investigate whether patients with the diagnosis of glaucoma, a poten- tially blinding chronic disease with minimal involvement of visual acuity in the early and moderate stages, have different functional status and well-being than patients without glau- coma. Methods Study Population The protocol was approved by the Institutional Review Board of the University of California, Los Angeles Health Sciences Center, and all participants signed informed consent. We prospectively enrolled patients with open-angle glaucoma and glaucoma sus- pects who were 18 years of age or older from two glaucoma specialty practices (MRW and ALC) and control subjects from the Originally received: March 24, 1998. Revision accepted: May 28, 1998. Manuscript no. 98158. 1 Jules Stein Eye Institute, University of California at Los Angeles, Los Angeles, California. 2 College of Medicine, Charles Drew University of Medicine and Science, Los Angeles, California. Supported in part by a grant from Research to Prevent Blindness. Address correspondence to M. Roy Wilson, MD, MS, Creighton Univer- sity, 2500 California Plaza, Omaha, NE 68178. 2112