Novel point-of-care biomarkers of the dry anophthalmic socket syndrome: tear film osmolarity and matrix metalloproteinase 9 immunoassay.

Purpose: To compare tear film osmolarity (TFO) values and matrix metalloproteinase 9 (MMP-9) levels between anophthalmic sockets and healthy fellow eyes and to assess the use of the MMP-9 and TFO as objective biomarkers for the dry anophthalmic socket syndrome (DASS).

Methods: In this prospective single-center study, the anophthalmic sockets and healthy fellow eyes of 98 unilateral anophthalmic patients were assessed using the ocular surface disease index (OSDI) questionnaire, InflammaDry® MMP-9 point-of-care immunoassay, TFO with TearLab™ Osmolarity System, and clinical conjunctival inflammation. MMP-9 concentration and conjunctival inflammation were graded semi-quantitatively.

Health Literacy in Patients Wearing Prosthetic Eyes: A Prospective Cross-Sectional Study.

Purpose: To investigate general and electronic health literacy (HL) levels in prosthetic eye wearing patients, to define factors associated with reduced HL, and to identify a potential healthcare gap.

Methods: In this prospective cross-sectional study 148 prosthetic eye wearers were screened using the 16-item European Health Literacy Survey Questionnaire (HLS-EU-Q16) and the 8-item electronic Health Literacy Scale (eHEALS). HLS-EU-16 and eHEALS scores were correlated to health levels, vision functioning, and sociodemographic factors.

Post-enucleation socket syndrome-a novel pathophysiological definition.

Background: The last definition of the post-enucleation socket syndrome (PESS) by Tyers and Collin-formulated almost 40 years ago in 1982-is predominantly based on the clinical characteristics and does not include the insights of newer studies into the pathophysiological mechanism of the PESS.

Methods: A systematic PubMed literature review regarding the pathophysiological mechanism of the PESS was performed, and results were comprised to give an overview of the current knowledge of the PESS including the exact pathophysiological mechanism.

Results: The primarily postulated pathophysiological mechanism of the PESS was the atrophy of orbital tissues, especially of fat, resulting in variable clinical findings.

Towards improving the biocompatibility of prosthetic eyes.

Prosthetic eyes are currently manufactured using Poly(methyl methacrylate) (PMMA) which is not an ideal material because it is hydrophobic. While significant research has investigated the benefits of hydrophilic materials for contact lenses, no such research has been carried out on hydrophilic materials for prosthetic eyes until now. In this study, different derivatives of Poly(ethylene glycol) (PEG) monomer and methyl methacrylate (MMA) monomer were grafted to PMMA using copolymerisation.

Dry anophthalmic socket syndrome - morphological alterations in meibomian glands.

Purpose: To evaluate morphological alterations of meibomian glands (MGs) in the dry anophthalmic socket syndrome (DASS).

Methods: Fifteen unilateral anophthalmic patients wearing cryolite glass prosthetic eyes were enrolled. All patients with clinical blepharitis or other significant eyelid abnormalities were excluded.

Anxiety and depression in patients wearing prosthetic eyes.

Purpose: To investigate anxiety and depression levels in prosthetic eye-wearing patients using standardized psychometric instruments, to define factors associated with these psychological diseases, and to identify a potential healthcare gap.

Methods: A total of 295 prosthetic eye wearers were screened using the 7-item generalized anxiety disorder scale (GAD-7) and the 9-item patient health questionnaire (PHQ-9). Scores of GAD-7 and PHQ-9 were correlated with scores of general physical and mental health functioning, vision-related quality of life, appearance-related distress, appearance-related social function, and further biosocial factors.

Depression, Anxiety and Stress Indicators for Prosthetic Eye Wearers.

Background: This study explores the role of appearance, mucoid discharge, visual perception and functional problems as indicators for depression, anxiety and stress amongst prosthetic eye wearers.

Methods: A total of 217 anophthalmic patients who had worn a prosthetic eye for at least two years and were older than 16 years completed an anonymous questionnaire. Descriptive and inferential statistics were used to investigate differences and correlations between variables.

Dry anophthalmic socket syndrome - Standardized clinical evaluation of symptoms and signs.

Objectives: To assess symptoms and signs of the dry anophthalmic socket syndrome (DASS) in a standardized manner.

Methods: 87 unilateral anophthalmic patients were evaluated using the Ocular Surface Disease Index (OSDI), the 5-Item Dry Eye Questionnaire (DEQ-5), and a modified version of Symptom Assessment iN Dry Eye (SANDE) questionnaire separately for the anophthalmic socket and for the healthy fellow eye. Conjunctival inflammation was semi-quantitatively graded and Schirmer I test with topical anesthesia was performed bilaterally.

Concerns regarding Indian prosthetic eye wearers.

Clinical Relevance: Loss of an eye has a negative impact on the psychological health of a person.

Background: The aims are to: (a) identify the concerns of experienced prosthetic eye wearers in representative areas of India; (b) investigate how they change over time; (c) study how some demographic characteristics influence concerns; and (d) compare prosthetic eye concerns in India versus Germany and New Zealand.

Methods: This observational multi-centre study was conducted in the cities of Mumbai, Bengaluru and Delhi.

Cryolite glass prosthetic eyes-the response of the anophthalmic socket.

Purpose: To investigate mucoid discharge and the inflammatory response of anophthalmic sockets to cryolite glass prosthetic eye wear.

Patients And Methods: A total of 101 cryolite glass prosthetic eye wearers used visual analog scales (0-10) to measure frequency, color, volume, and viscosity of mucoid discharge associated with their prosthesis. Standardized photographs of the conjunctiva of their anophthalmic sockets were taken and conjunctival inflammation was semi-quantitatively graded (0-4).

Concerns of anophthalmic patients-a comparison between cryolite glass and polymethyl methacrylate prosthetic eye wearers.

Purpose: To compare the concerns of experienced cryolite glass and (poly)methyl methacrylate (PMMA) prosthetic eye wearers.

Methods: One hundred six experienced cryolite glass and 63 experienced PMMA prosthetic eye wearers completed an anonymous questionnaire regarding general and specific prosthetic eye concerns at least 2 years after natural eye loss. From these independent anophthalmic populations, we identified 34 case-control pairs matched for the known influencing demographic variables of gender, occupation, age, and time since natural eye loss.

Concerns of Anophthalmic Patients Wearing Cryolite Glass Prosthetic Eyes.

Purpose: To identify the main concerns of patients experienced in wearing cryolite glass prosthetic eyes and to investigate how these have changed over time.

Methods: One hundred six patients experienced in wearing prosthetic eyes for at least 2 years were asked to complete an anonymous questionnaire regarding prosthetic eye concerns at the time of initial eye loss and at the present time. Main outcome measures included changes in levels of concern over time.

An investigation into discharge, visual perception, and appearance concerns of prosthetic eye wearers.

We investigate prosthetic eye wearers' initial and current concerns about mucoid discharge, visual perception, and appearance, and the reasons for their concerns. A retrospective, cross-sectional study of private practice patients was designed. Participants were 217 experienced prosthetic eye wearers, aged at least 16 years.

A proposed model of the response of the anophthalmic socket to prosthetic eye wear and its application to the management of mucoid discharge.

Mucoid discharge associated with prosthetic eye wear can be a distressing condition that affects the quality of life of people who have lost an eye. Discharge is the second highest concern of experienced prosthetic eye wearers after health of the companion eye and is prevalent in anophthalmic populations. Specific causes of mucoid discharge such as infections and environmental allergens are well understood, but non-specific causes are unknown and an evidence based protocol for managing non-specific discharge is lacking.

Deposit buildup on prosthetic eye material (in vitro) and its effect on surface wettability.

Background: The aim of this in-vitro study was to investigate the effect of different polishing standards on prosthetic eye material (poly(methyl methacrylate) [PMMA]) on surface wettability and the rate of protein and lipid buildup.

Methods: Sample disks (12 mm diameter × 1 mm thickness) of PMMA were polished to three different standards of surface finish: low, normal, and optical quality contact lens standard. The sample disks were incubated in a protein-rich artificial tear solution (ATS) for the following periods of time: 1 second, 30 minutes, 1 hour, 4 hours, 24 hours, and 14 days.

The response of the anophthalmic socket to prosthetic eye wear.

Purpose: The aim of this study was to investigate the inflammatory response of the anophthalmic socket to prosthetic eye wear.

Methods: One hundred and two prosthetic eye wearers were recruited for this observational study. Photographic grading scales were used to measure the severity of conjunctival inflammation and the extent and intensity of stained deposits on the prosthetic eyes.

Biosocial profile of New Zealand prosthetic eye wearers.

Aim: To describe the biosocial profile of New Zealand (NZ) artificial eye wearers and establish a basis for future research and international comparison.

Methods: This retrospective study surveyed 431 NZ artificial eye wearers to investigate their ethnicity, gender, age, causes of eye loss, age of current prosthesis, ocular prosthetic maintenance regimes and the extent and severity of discharge associated with prosthesis wear.

Results: Approximately 3000 people wear artificial eyes in NZ.

Deposit buildup on prosthetic eyes and implications for conjunctival inflammation and mucoid discharge.

Background: The aim of this study was to investigate deposit buildup on prosthetic eyes and the implications for conjunctival inflammation and discharge.

Methods: Forty-three prosthetic eye wearers participated in the study. Twenty-three had their prostheses polished normally before being worn continuously for 2 weeks.

The development of measurement tools for prosthetic eye research.

Background: The aim was to develop tools to measure the condition of ocular prostheses and the socket's response to prosthetic eyewear.

Methods: A novel staining technique for displaying deposits on prosthetic eyes was developed. Equal interval perceptual grading scales for measuring inferior palpebral conjunctival inflammation, and anterior and posterior stained surface deposits on prosthetic eyes were developed from 800 photographs of 43 volunteers.