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.