Abstract Background: Diabetic retinopathy (DR) is a leading cause of visual impairment in working-age adults and can affect daily functioning, psychological well-being, and professional performance. This study aimed to assess quality of life (QoL) in active members of internal security forces (ISF) with DR and identify influencing factors. Methods: The cross sectional study was conducted from October 2025 to February 2026 at the Ophthalmology Department of the ISF Hospital in Marsa. One hundred active ISF members with DR were included. QoL was assessed using the NEI VFQ-25 questionnaire, with a score ≥70 indicating good QoL. Results: The mean age was 45.55 ± 8.55 years, with a male predominance (78%). The mean overall QoL score was 61.35 ± 22.52. Higher scores (>70) were observed in color vision, social functioning, peripheral vision, and vision-related dependency. Bivariate analysis identified several factors associated with QoL, including gender, diabetes type, glycemic control, neuropathy, nephropathy, hypertension, vitreoretinal surgery, DR stage, central macular thickness, vitreous hemorrhage, and tractional retinal detachment. Multivariate analysis showed that male gender, absence of neuropathy, absence of nephropathy, and history of vitreoretinal surgery significantly influenced overall QoL. The “Subjective Experience and Psychosocial Impact” domain had the lowest scores, while “Activities of Daily Living and Autonomy” had the highest. Absence of neuropathy was the main factor affecting psychosocial impact. Conclusion: DR significantly impairs QoL in active ISF members, particularly psychosocial aspects. This impact is linked to systemic complications and treatment history, highlighting the importance of early, comprehensive management including QoL assessment.

Houda Lajmi is a 41 years-old ophthalmologist, professor in the Faculty of Medicine of Tunis; Member of the Ethics Committee of the Faculty of Medicine of Tunis. She holds a university degree in: research methodology, health sciences pedagogy, public health, bioethics, leadership and management in health, headache and migraine, and contactology