Quality of life in patients with Graves ophthalmopathy.

PURPOSE To assess the quality of life in patients with Graves ophthalmopathy by means of a prospective questionnaire with validation. METHODS A questionnaire containing 105 items was sent to 325 patients seen in our university-based oculoplastic clinic. Two hundred three questionnaires were returned and were suitable for analysis. Fifty-three consecutive patients with Graves disease who presented to the clinic for examination also completed the questionnaire. The questionnaire was validated by administering it to 33 healthy subjects who had no history of Graves disease or thyroid disorder. The results were compared with those of normal subjects and with national norms for visually impaired populations. The relationship of individual questionnaire items to measures of clinical severity was subsequently assessed. RESULTS Patients with Graves ophthalmopathy report greater impairment in both physical (44.4 versus 51.9; P < .001) and mental (43.8 versus 51.8; P < .001) health; poorer self- image (P < .001); and significantly more disturbance in their sleep, social function, and work function (P < .001) than controls. Afflicted patients also experience significantly more diplopia, blurred vision, and dry eye symptoms than controls (P < .001). Individual questionnaire items were found to correlate with clinical disease severity scores and were used to establish a Graves ophthalmopathy quality-of-life questionnaire with disease severity validation. CONCLUSIONS Patients with Graves disease are significantly impaired in their social and vocational function because of the ophthalmic manifestations of the disease. A short questionnaire that correlates with clinical measures of disease severity may be a useful measure of quality of life in this disease.