Purpose: To determine how glaucoma patients with various degrees of vision loss rate their vision, and to determine if the Esterman binocular visual field test and other visual function tests correlate with those ratings.Methods: Two hundred thirty-seven glaucoma patients evaluated their vision using 2 utility tests, the linear rating scale and the time trade-off test, and 2 quality-of-life instruments, the National Eye Institute Visual Function Questionnaire (VFQ) and the Short Form 36 (SF-36). Their results were compared to clinical tests of their vision and to persons with normal vision (n=12) and blind persons (n=12).Results: On a scale of 0 (blind) to 100 (ideal), subjects with normal vision rated their vision higher (90 ± 8.0) than did glaucoma subjects and suspects (75.7 ± 17.6) and "blind' subjects (15.6 ± 15.3), P =.001. Mean scores for the Esterman test were 89.7 ± 13.4 for the glaucoma group. The Esterman test correlated moderately with the overall VFQ score (partial correlation coefficient [PCC] = 0.32, P = .001), but only weakly with the linear rating scale (PCC = 0.17, P = .02) and the time trade-off test (PCC = -0.16, P = .06). Correlation between the linear rating scale and the overall VFQ score was good (PCC = 0.56, P = .0001) and was moderate with several domains of the SF-36 (eg, social function PCC = 0.32, P = .0001). Conclusions: Utility values that glaucoma patients assign to their vision do not correlate well with Esterman test results.A challenge for the future will be designing clinical tests that better correlate with patient perceptions.

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Objective: To determine the importance that patients place on the characteristics of topical therapy for lowering intraocular pressure. Methods:We administered a willingness-to-pay instrument to 230 patients from 4 glaucoma subspecialty practices, asking them how much they would be willing to pay to obtain particular characteristics in an eye drop. Data about the subjects' demographics, economic status, attitudes toward eye drops and systemic medications, and symptoms from eye drops were correlated with their willingness to pay using 2-part models.Results: Of our subjects, 169 (77%) were using eye drops to lower their intraocular pressure. Fatigue, blurred vision, and tearing were the most commonly reported symptoms. Eye drop medications most valued by the subjects did not produce blurring, drowsiness, or inhibition of sexual performance; 85% were willing to pay more for an eye drop that did not cause blurring, and on average they were willing to pay 40% more. Higher educational levels and income were generally associated with a willingness to pay more for eye drops with desirable attributes.Main Outcome Measure: Willingness to pay more (in dollars).Conclusions: Patient preferences for eye drop characteristics can be assessed using a willingness-to-pay instrument. Patients place differing value on various eye drop characteristics. A better understanding of patient preference could lead to better compliance.