Evaluation of the psychological effect and vision related quality of life enucleated/eviscerated patients with prosthetic eyes

Introduction: Patients with acquired anophthalmia post evisceration or enucleation surgeries are confronted with the loss of an eye as well as the pathological process which led to the surgery being performed. The regular use of prosthetic eyes in these patients has helped them to achieve a reasonable cosmetic outcome post operatively. Psychological sequelae of anopthalmia and prosthetic eye wear is often not addressed by the treating physician. Thus, identification of such sequelae may be helpful to these patients and others in the future so that they may referred to the appropriate channels for further evaluation. Objective: The aim of our study was to evaluate the levels of anxiety, depression and vision related quality of life in patients with prosthetic eyes post evisceration or enucleation and to determine the potential predictors associated with it. Methods: A cross sectional study was conducted between March 2017 and March 2018 involving patients with prosthetic eyes post evisceration or enucleation attending eye clinics of two tertiary hospitals in Malaysia; Hospital Selayang and Hospital Universiti Sains Malaysia.The patients were given two validated questionnaires: The National Eye Institute Visual Function Questionnaire – (NEI-VFQ) and the Hospital Anxiety and Depression (HADS) questionnaire. After completion, the questionnaires were calculated and scored, and statistical analysis was done using Statistical Package for the Social Science (SPSS Inc Version 22). Results: A total of 54 patients with acquired anophthalmia with prosthetic eyes participated in the study. The demographic and clinical variables that were assessed were age, gender, race, marital status, highest education level, monthly household income, reason for enucleation/evisceration and duration of prosthesis wear. The mean composite visual related quality of life was reduced with a score of 75.97. The minimum composite score was 18.75 and the maximum composite score was 100. The mean HADS (D) depression score was 1.94 with a range of scores from 0 to 8. 53 patients had normal scores and only one had a score of more than 8. The mean HADS(A) Anxiety score was 3.61 with a range of scores from 0-10.48 patients had normal scores, and 6 patients had scores of more than 8. A score of more than 8 represents mild depression or anxiety. There were no significant associations between the demographic and clinical variables with vision related quality of life and depression levels based on the simple and multiple linear regression formulas (p>0.05 for all variables tested). There were significant associations between demographic and clinical variables with increased anxiety levels where p