Perceived Stress Levels and Associated Factors in Adult Patients with Primary Open-angle Glaucoma: A Prospective Survey Study

PURPOSE: To investigate adult primary open-angle glaucoma (POAG) patients’ perceived stress levels and to examine the associations with their clinical characteristics. METHODS: Sixty-seven POAG patients, excluding those meeting the exclusion criteria (retinal or neurological disease diagnoses) comprised the study population. A validated questionnaire, namely Perceived Stress Scale-10 (PSS-10), was used to assess stress level. Additional data on glaucoma surgery history, medical benefit receipt, comorbidities, and daily antiglaucoma medication number were collected. The clinical characteristics of high (PSS-10 ≥15) and low stress (PSS-10 <15) patients and the risk factors associated with high stress level were subjected to a multivariable logistic regression analysis. RESULTS: The patients were 56.8 ± 12.6 years of age on average, and 29 (43.3%) were female. The mean PSS-10 level was 13.5 ± 5.3 (range, 1–27) for the entire patient group; 31 patients (46.3%) were in the high stress group. In the high stress group relative to the low stress group, best-corrected visual acuity in the better eye was lower (p = 0.044) and the visual field defects, in both eyes, were more severe (better eye, p = 0.005; worse eye, p = 0.026). A logistic regression analysis indicated that severe visual field defect in the better eye (odds ratio, 1.159; 95% confidence interval, 1.016–1.323; p = 0.028) and lower best-corrected visual acuity in the better eye (odds ratio, 4.707; 95% confidence interval, 0.580–6.189; p = 0.072) were both likely to associated with high stress level in patients with POAG. CONCLUSIONS: These findings suggest an association between severe visual function loss and higher mental stress level in POAG patients. Stress level, therefore, might be an important consideration in POAG patient management.