Quality of life in Graves' ophthalmopathy.

General health-related quality-of-life (QoL) questionnaires (MOS SF-24 and SF-36) and the more sensitive disease-specific QoL questionnaire (GO-QoL) both indicate substantial impairment of quality of life in patients with Graves' ophthalmopathy (GO). The GO-QoL contains 8 questions on visual functioning and 8 questions on appearance; answers on each subscale are transformed to scores ranging from 0 (worst) to 100 (best). The minimal clinically important difference in scores is ≥10 points for invasive therapies, but a change of 6 points on one of both subscales is already perceived by patients as beneficial and associated with an important change in daily functioning. The GO-QoL is well validated, widely used, and available in eight languages. The GO-QoL is recommended as an independent primary outcome measure in randomized clinical trials. Incorporating the GO-QoL in the routine assessment of GO in daily clinical practice is also recommended: although unproven, it is likely to improve the quality of care by identifying patients who are in need for psychological support in order to address poor psychosocial functioning and low self-esteem.