Health-Related Quality of Life After Surgical Removal of an Eye

Abstract

Purpose This study compared the general health related quality of life (HRQOL) and the vision specific HRQOL in patients following the surgical removal of one eye who had good vision in the remaining eye to a group of binocular patients with good vision in both eyes. Methods The Medical Outcomes Study Short Form 12 (SF-12) and the National Eye Institute Visual Function Questionnaire (NEI VFQ) health related quality of life (HRQOL) surveys were administered to 29 patients who had surgical removal of an eye who attended an ocular prosthetics clinic and to 25 binocular persons who accompanied a patient. All subjects in each group had best corrected visual acuity of 20/40 or better. Overall statistical significance was tested using Cramer's V followed by individual t-tests for independent groups for each of the scales on the two questionnaires to determine if the means between the two groups differed statistically. Results The patient group had a mean age of 50.98 years (range 19 to 76). The control group had a mean age of 49.46 years (range 18 to 76). The mean time after loss of vision was 28.03 years (range 1-71 years) and the mean time from surgical removal of the eye was 23.6 years (range 0.5 to 59.5). There was an overall significant difference between the two groups on the 15 derived subscales of the two forms (Cramer's V, p = 0.0025). Three general HRQOL subscales (SF-12- mental component summary (MCS), SF-12 physical component summary (PCS), NEI VFQ-General Health) showed no differences between the two groups (p = 0.48, p = 0.81, p = 0.78 respectively). Three of the twelve vision specific NEI VFQ subscales demonstrated statistically significant differences between the patient and control groups: peripheral vision (p = 0.0006), role difficulties (p = 0.015) and the composite score (p = 0.014). Additionally, two monocular patients had given up driving compared to no binocular subjects (p = 0.056). Conclusions This population of monocular patients had general physical and mental HRQOL equivalent to the normal binocular group despite the surgical removal of one eye. However, the reduced vision specific HRQOL of monocular patients on the NEI VFQ indicates that there are substantial residual visual deficits even after prolonged monocular status.

Vision-Related Quality of Life and Appearance Concerns Are Associated with Anxiety and Depression after Eye Enucleation: A Cross-Sectional Study

“…The mean vision-specific composite score of 70.3 in this study was lower than scores of approximately 80 in both Kondo et al’s and Hirneiss et al’s studies, which may be due to distinct participant characteristics and rehabilitation programs [ 6 , 7 ]. Many aspects of vision-related quality of life are associated with mood states after eye removal.…”

Compliance With Protective Lens Wear in Anophthalmic Patients

“…1,2,5,9–14 In binocular patients that experience a loss of acuity in one eye, the visual pathway’s plasticity allows recalibration of the spatial processing system, which promotes adaptation to monocular functioning. Furthermore, the up-recruitment of cross-modal systems enhance function.…”

“…4 This allows monocular patients to have comparable physical and mental health scores to binocular patients, despite some limitation in visual function. 5 …”

“…4 This allows these individuals to adapt well with function and quality of life that rivals their binocular counterparts. 5 However, the reduction of visual field and loss of depth perception increases the risk of a future traumatic injury compared to individuals with normal binocular acuity. 6 Further injury to the remaining sighted eye severely reduces quality of life and ability to function 6,7 ; thus making the use of protective lensed paramount in monocular individuals.…”

Prostetic Rehabilitation of an Eye Globe: Case Report

“…A patient's self-judgment can lead to emotional instability, change in personality characteristics, and change in socialization (2). Surgical removal of an eye can result in depression, difficulties in performing any activity, such as driving a vehicle, and aesthetic problems (3).…”