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Abstract
Purpose: To study the health profiles and behavioral differences between primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) patients.
Methods: Confidential mail survey of ICD-9 defined POAG (n = 277) and NTG (n = 116) patients was carried out to collect information regarding age, gender, height, weight, waist circumference, blood pressure (BP), medications [prescription (Rx) and over the counter (OTC)], education, and the Short Health Anxiety Inventory (SHAI).
Results: NTG patients (59/116) were significantly more likely to respond to the survey than POAG patients (43/277), p = 0.0001, and to have obtained college level education (70% vs. 42%), p = 0.003. Body weight, waist circumference, body mass index, systolic BP, pulse pressure, and ratio of prescription medications to OTC medications were significantly lower in the NTG group (p < 0.0001). The SHAI score, mean age, and diastolic BP were not different between the two groups. A subgroup analysis of college-educated patients in both groups revealed persisting significant differences in waist circumference, systolic BP, and ratio of Rx to OTC medications.
Conclusions: NTG patients do not have significantly greater health anxiety than POAG patients. NTG patients are more likely to have lower BMI, systolic BP, and ratio of Rx to OTC medications than POAG patients. The pilot nature of this study limits generalizability of these findings. Larger studies confirming these findings and elucidating the role of refractive error and medical history on such differences are needed.
ACKNOWLEDGMENTS
This work was supported by an unrestricted departmental grant from Research to Prevent Blindness, Inc., New York, New York. Dr. Asrani is a recipient of the Career Development Award from Research to Prevent Blindness, Inc., New York, New York.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.
APPENDIX 1
Glaucoma Questionnaire
A. Please answer the following questions about yourself:
Gender: Male Female (Circle one)
Current age: ___________years
Height: _________feet __________inches
Weight: _________pounds
Blood pressure (measured at home or in a pharmacy): ___/___
Waist circumference (measured at the level of the navel): _____inches
Highest educational qualification obtained:
B. Please list all medications, including eye drops, creams, inhalations, vitamins, and herbal supplements used. Please use an additional sheet if necessary.
C. Please choose (circle) one of the following statements about yourself:
I never or rarely forget to take my daily medications.
I sometimes forget to take my daily medications.
I often forget to take my medications.
D. Each question is this section consists of a group of four statements. Please read each group of statements carefully and then select the one that best describes your feelings over the past six months. Identify the statement by circling the letter next to it, i.e., if you think that statement (a) is correct, encircle the letter (a); it may be that more than one statement applies to you, in which case, please encircle any that are applicable.
1. (a) I do not worry about my health.
(b) I occasionally worry about my health.
(c) I spend much of my time worrying about my health.
(d) I spend most of my time worrying about my health.
2. (a) I notice aches/pains less than most other people (of my age).
(b) I notice aches/pains as much as most other people (of my age).
(c) I notice aches/pains more than most other people (of my age).
(d) I am aware of aches/pains in my body all the time.
3. (a) As a rule I am not aware of bodily sensations or changes.
(b) Sometimes I am aware of bodily sensations or changes.
(c) I am often aware of bodily sensations or changes.
(d) I am constantly aware of bodily sensations or changes.
4. (a) Resisting thoughts of illness is never a problem.
(b) Most of the time I can resist thoughts of illness.
(c) I try to resist thoughts of illness but am often unable to do so.
(d) Thoughts of illness are so strong that I no longer even try to resist them.
5. (a) As a rule I am not afraid that I have a serious illness.
(b) I am sometimes afraid that I have a serious illness.
(c) I am often afraid that I have a serious illness.
(d) I am always afraid that I have a serious illness.
6. (a) I do not have images (mental pictures) of myself being ill.
(b) I occasionally have images of myself being ill.
(c) I frequently have images of myself being ill.
(d) I constantly have images of myself being ill.
7. (a) I do not have any difficulty taking my mind off thoughts about my health.
(b) I sometimes have difficulty taking my mind off thoughts about my health.
(c) I often have difficulty in taking my mind off thoughts about my health.
(d) Nothing can take my mind off thoughts about my health.
8. (a) I am lastingly relieved if my doctor tells me there is nothing wrong.
(b) I am initially relieved but the worries sometimes return later.
(c) I am initially relieved but the worries always return later.
(d) I am not relieved if my doctor tells me there is nothing wrong.
9. (a) If I hear about an illness I never think I have it myself.
(b) If I hear about an illness I sometimes think I have it myself.
(c) If I hear about an illness I often think I have it myself.
(d) If I hear about an illness I always think I have it myself.
10. (a) If I have a bodily sensation or change I rarely wonder what it means.
(b) If I have a bodily sensation or change I often wonder what it means.
(c) If I have a bodily sensation or change I always wonder what it means.
(d) If I have a bodily sensation or change I must know what it means.
11. (a) I usually feel at very low risk for developing a serious illness.
(b) I usually feel at fairly low risk for developing a serious illness.
(c) I usually feel at moderate risk for developing a serious illness.
(d) I usually feel at high risk for developing a serious illness.
12. (a) I never think I have a serious illness.
(b) I sometimes think I have a serious illness.
(c) I often think I have a serious illness.
(d) I usually think that I am seriously ill.
13. (a) If I notice an unexplained bodily sensation I don’t find it difficult to think about other things.
(b) If I notice an unexplained bodily sensation I sometimes find it difficult to think about other things.
(c) If I notice an unexplained bodily sensation I often find it difficult to think about other things.
(d) If I notice an unexplained bodily sensation I always find it difficult to think about other things.
14. (a) My family/friends would say I do not worry enough about my health.
(b) My family/friends would say I have a normal attitude to my health.
(c) My family/friends would say I worry too much about my health.
(d) My family/friends would say I am a hypochondriac.