Glaucoma is a chronic disease that causes loss of vision and potentially blindness as a result of optic nerve damage, often due to increased intraocular pressure. Glaucoma is currently the leading cause of irreversible blindness worldwide.1 In 2020, 4.1 million and 3.6 million adults over the age of 50 suffered from mild to severe glaucoma-induced visual impairment and blindness, respectively.1 However, these figures are likely underestimated since glaucoma can remain asymptomatic until later stages in disease progression.2 The relaxation response evoked by mind-body interventions, such as breathing exercises and meditation, is known to reduce stress and improve quality of life (QOL). In a recent study, mindfulness-based meditation was found to reduce intraocular pressure and improve QOL in patients with glaucoma.3 A feasibility study will be conducted using a mixed-method design to assess the feasibility of the online delivery of meditation for potentially enhancing the QOL and reducing stress in glaucoma patients. Upon recruitment, participants will undergo blocked randomization to either the intervention arm or usual care arm. Participants in each arm will complete online questionnaires at baseline and weeks 1, 3, 6, and 12 to collect data on health-related quality of life (HRQOL), perceived stress, and behaviour using REDCap. REDCap is an online data collection and survey tool hosted by the Office of Research Services of Lawson Research Institute. Our study can help to assess the feasibility of conducting a study on breathing exercises followed by meditation to assess its effects in a sample of patients with glaucoma.
Diagnosed with glaucoma or suspected to have glaucoma.
Aged 65 and above.
Able to provide valid informed consent to participate in the research study.
Able to read and understand English.
Inability to provide valid informed consent.
Significant communication barriers or lack of English proficiency that prevents participants from completing the questionnaires.
Self-reported substance abuse or dependence within the past 3 months.
Having acutely unstable medical illnesses, including delirium or acute cerebrovascular or cardiovascular events within the last 6 months.
Parallel
Meditation + Usual Care
Other interventionMeditation is a guided technique that helps to reduce stress, therefore inducing physiological and mental relaxation whilst the eyes are shut.
Incidence of Quality of Life as measured by GQOL- 15 in Glaucoma Patients
HRQoL will be assessed using Glaucoma Quality of Life-15 (GQL-15). GQL-15 is a disease-specific, validated, self-administered questionnaire designed to measure HRQoL in patients with glaucoma. The questionnaire comprises of 15 items on daily functioning across 5 factors: central and near vision (2 items), peripheral vision (6 items), glare and dark adaptation (6 items), and outdoor mobility (1 item). Patients rate these questions on a 5-point Likert scale of difficulty ranging from "1 = no difficulty" to "5 = severe difficulty".
Incidence of Stress as Measured by PSS-10 in Glaucoma Patients
The Perceived Stress Scale (PSS-10) is a 10-item questionnaire widely used to measure the perception of stress. It is a measure of the degree to which situations in one's life are appraised as stressful. Items were designed to tap how unpredictable, uncontrollable, and overloaded respondents find their lives. The scale also includes several direct queries about current levels of experienced stress. Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress. Scores ranging from 0-13 would be considered low stress; scores ranging from 14-26 would be considered moderate stress; and scores ranging from 27-40 would be considered high perceived stress.
Incidence of Behavior as measured by Consideration of Future Consequences - 14 (CFC-14) in Glaucoma Patients
In previous research, consideration of future consequences (CFC) has been recognized as a critical factor influencing individuals' engagement in health-promoting behaviors. Strathman et al. initially developed a 12-item unidimensional Consideration of Future Consequences (CFC) scale to measure individual differences in temporal orientation. This scale assesses the degree to which individuals consider the potential impact of their current behavior on immediate or distant outcomes.38 Low CFC scores indicate that individuals are more inclined to pursue immediate rewards, whereas high scores are observed among individuals who prioritize future advantages and sacrifice immediate gratification.
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