Maja BELEVSKA, Sotir ROPI, Elena KRSTEVSKA-KELEPUROVSKA
Medical Science and Discovery - 2026;13(6):103-109
Objective: Low vision affects mobility, autonomy, social participation and work capacity, yet generic health-related quality of life (HRQoL) data in adults with low vision remain limited in South-Eastern Europe. This study assessed HRQoL and self-rated health in adults with low vision and compared ophthalmic subgroups with a control group. Methods: This cross-sectional analytical study included 600 adults from urban and rural areas of North Macedonia: 450 adults with low vision and 150 controls with preserved vision. Cases comprised 150 participants with glaucoma, 150 with diabetic retinopathy and 150 with refractive anomalies. Participants were distributed across labour, clerical or administrative, agricultural and other occupations. HRQoL was assessed with the Serbian-language EQ-5D-3L and self-rated health with EQ-VAS. Results: Moderate problems predominated in mobility (288/450, 64.0%), self-care (301/450, 66.9%), usual activities (293/450, 65.1%) and anxiety/depression (245/450, 54.4%) among low-vision cases. Most low-vision participants reported no pain/discomfort (359/450, 79.8%), although glaucoma showed more severe pain/discomfort than diabetic retinopathy (chi²=11.101, p=0.0041) and refractive anomalies (chi²=11.401, p=0.0031). Controls had better EQ-5D profiles than all low-vision groups across all five domains and in aggregate graded EQ-5D levels. Between diagnostic groups, no meaningful differences were observed for mobility, self-care, usual activities, anxiety/depression or aggregate EQ-5D levels. Derived EQ-VAS mean+/-SD values were 62.1+/-13.9 in glaucoma, 53.5+/-14.8 in diabetic retinopathy, 60.1+/-14.2 in refractive anomalies, 58.2+/-15.2 in all low-vision cases and 71.3+/-12.9 in controls. EQ-VAS distributions differed between glaucoma and diabetic retinopathy and between diabetic retinopathy and refractive anomalies, but not between glaucoma and refractive anomalies. Conclusion: Adults with low vision had substantially poorer HRQoL and worse self-rated health than controls, with the greatest burden in mobility, self-care, usual activities and emotional wellbeing. These findings support integrated ophthalmic, rehabilitative, psychosocial and workplace-oriented interventions.
