Abstract:
Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus
(DM), arising from retinal vascular damage due to prolonged hyperglycemia. It is a leading
cause of vision loss among working-age adults globally. This study aimed to assess visionrelated
quality of life (VRQoL) and its associated factors among patients with DR at the National
Eye Hospital of Sri Lanka. A descriptive cross-sectional study was conducted among 289
DR patients attending the eye clinic, selected using convenience sampling. Data were collected
using an interviewer-administered NEI-VFQ-25 questionnaire and analysed using SPSS version
25. Of the participants, 61% were female, 73.5% were aged above 60 years, 94.4% were Buddhist,
and 94.4% were Sinhalese. Most were married (96.3%) and literate, with 35.8% educated
up to O/L. More than half (54.5%) reported poor overall health, and 49.7% experienced ocular
pain or discomfort. Difficulties were common in reading printed materials (49.7%), cooking/
sewing (49.7%), going down steps in dim light (32.8%), and matching clothes (54.5%).
Driving limitations were substantial—59.7% had given up driving, and 62.8% reported extreme
difficulty driving at night. The mean composite VRQoL score was 58.8±18.7, highest for social
functioning (98.0±24.2) and lowest for driving (37.5±36.5). QoL declined significantly
with age (p = 0.02) and was lower among patients with proliferative DR (32.1±16.3) compared
to non-proliferative DR (51.6±21.5) (p < 0.001). Type II DM patients had significantly
higher QoL scores (42.8±20.9) than those with Type I DM (31.0±17.8) (p = 0.01). Marital status
(p< 0.001) and educational qualification (p = 0.02) were also significantly associated with
QoL. Visual acuity and perimetry mean deviation in both eyes showed strong correlations with
VRQoL scores (p<0.05). DR significantly impairs VRQoL, particularly in domains of driving,
near/distant activities, and independence. Older age, advanced DR stage, Type I DM, and lower
education are associated with poorer QoL. Routine VRQoL assessments and tailored interventions
are recommended to optimise patient management, preserve functional independence, and
improve overall well-being.
