RESUMO
Anophthalmic patients not only cause obvious functional deficits and facial deformities, but lead to poor psychological outcomes, although prosthesis wearing can offer improvements in psychological well-being to some extent. The study aimed to comprehensively evaluate the psychological symptoms and analyze related factors in anophthalmic patients wearing ocular prosthesis.Total of 150 anophthalmic patients and 120 control subjects were included in this cross-sectional study. Baseline characteristics survey and the symptom checklist-90 scale were completed by all participants to assess the psychological symptoms and analyze their related factors by multivariate analysis.The anophthalmic patients exhibited the increased levels of somatization, depression, anxiety, and hostility compared with control subjects. The most prominent symptom was hostility with the median score of 1.20. Female patients presented with higher somatization, depression, anxiety, and hostility. Marital status single was positively associated with depression, anxiety, and hostility symptoms. Lower education and cause of enucleation were related to higher levels of hostility.Anophthalmic patients wearing ocular prosthesis presented with more prominent hostility and somatization besides its higher depression and anxiety symptoms. The findings suggest that for female single anophthalmic patients with low education, especially caused by trauma, timely psychological assessment and intervention should be provided to avoid undesirable consequences.
Assuntos
Anoftalmia/psicologia , Olho Artificial/psicologia , Adulto , Anoftalmia/complicações , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos de Casos e Controles , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Feminino , Humanos , Masculino , Estado Civil , Pessoa de Meia-Idade , Fatores de Risco , Transtornos Somatoformes/epidemiologia , Transtornos Somatoformes/etiologia , Inquéritos e Questionários , Adulto JovemAssuntos
Emoções/fisiologia , Olho Artificial/psicologia , Adulto , Feminino , Humanos , Masculino , Inquéritos e QuestionáriosRESUMO
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. RESULTS: Initially, the participants were mainly concerned about their appearance, health of the fellow eye, and coping with monocularity. Over time, there was a significant increase of the level of concern regarding the health of the remaining eye (p < 0.001) and regarding watering, crusting, and discharge (p < 0.001). Loss of balance did not change significantly (p = 0.302). All other concerns decreased significantly over time (p < 0.001), with levels of concern about appearance decreasing the most. The current leading concern was the health of the remaining eye followed by concerns about watering, crusting, and discharge. Length of time since natural eye loss was the most important explanatory variable, with significant impact on the concerns about appearance (p = 0.013), retention of the prosthetic eye (p = 0.002), and eyelid contour (p = 0.004). CONCLUSIONS: Health of the remaining eye is the most common current concern of anophthalmic patients, acknowledging the need of good ophthalmologic follow up after losing an eye. The second most important concern is with watering, crusting, and discharge, suggesting further research for establishing an evidence-based protocol for cryolite glass prosthetic eye maintenance and supportive treatment.
Assuntos
Anoftalmia/psicologia , Olho Artificial/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anoftalmia/cirurgia , Criança , Estética , Oftalmopatias/psicologia , Feminino , Lateralidade Funcional , Vidro , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Fluoreto de Sódio , Adulto JovemRESUMO
AIM: rectification of indications and contraindications for ectoprosthetics and exploration of its potential as a modern rehabilitation modality. MATERIAL AND METHODS: Here are summarized the results of 89 cases of facial reconstruction with prosthetic means in trauma patients and those who had had congenital or oncological pathology and in whom other methods of rehabilitation were unable to remedy the defect within the orbital region. RESULTS: The indications and contraindications for facial prosthetics as well as the conditions, under which this type of medical and social rehabilitation can be carried out, were clarified. The authors also explained the process of creating an epiprosthesis and how it should be attached to the orbit to have the maximum effect on the existing defects of both the bone and auxiliary apparatus (including eyelid soft tissues, eyelashes, etc.). Because modern ectoprostheses are made of silicone and held in place with magnets, they provide an optimal cosmetic result, so that, regardless of patient's age, no rough defects can be detected on the affected side at a 2-m distance. CONCLUSION: As the production technology develops, the cosmetic appearance of epiprostheses improves and their use broadens.
Assuntos
Olho Artificial , Implantes Orbitários , Procedimentos de Cirurgia Plástica , Adolescente , Adulto , Anoftalmia/complicações , Anoftalmia/reabilitação , Criança , Ajustamento Emocional , Olho Artificial/psicologia , Olho Artificial/normas , Traumatismos Faciais/complicações , Traumatismos Faciais/reabilitação , Neoplasias Faciais/complicações , Neoplasias Faciais/reabilitação , Feminino , Humanos , Masculino , Doenças Orbitárias/etiologia , Doenças Orbitárias/cirurgia , Procedimentos de Cirurgia Plástica/instrumentação , Procedimentos de Cirurgia Plástica/métodosRESUMO
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. An anonymous questionnaire was e-mailed or mailed to participants. Descriptive and inferential statistics were used to investigate differences or correlations between variables. Content analysis was used to analyze participants' open responses. Participants were equally concerned about discharge, visual perception, and appearance during the first three months following eye loss and at least 2 years later, even though their concerns decreased. Older participants were less concerned about appearance, while females were more concerned about current discharge and appearance. The greater the frequency and volume of discharge, the greater was the concern. Participants' initial discharge concern was due to a negative interpretation of what it meant, but later, it was due to discomfort from wiping, and how discharge looked to others. Loss of depth perception and reduced visual range were equally concerning. Initial appearance concerns related to disguisability of the prosthesis, but over time, changes to the socket and eyelids became more important. Loss of self-image is commonly considered to be the major concern of anophthalmic patients, but discharge and visual perception concerns are of equal importance. Reasons given for these concerns provide greater insight into patients' personal experience of eye loss.
Assuntos
Líquidos Corporais/metabolismo , Imagem Corporal/psicologia , Olho Artificial/psicologia , Muco/metabolismo , Órbita/fisiologia , Percepção Visual/fisiologia , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pacientes/psicologia , Qualidade de Vida , Estudos Retrospectivos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Ocular prosthetics make a decisive contribution to the functional, esthetic and psychosomatic rehabilitation of patients after ocular extirpation. OBJECTIVES: This article provides an overview of the fitting, daily care and complications of ocular prosthetics. METHODS: The study comprised a PubMed literature review and own clinical results. RESULTS: Ocular prosthetics made from cryolite glass or perspex can be manufactured and fitted 5-8 weeks after removal of the eye. During this period a conformer is placed within the conjunctival sac in order to prevent scar formation and shrinking of the socket. Artificial eyes can be worn continuously, only interrupted by a short but regular cleaning procedure. Artificial tears and lid hygiene improve the comfort of wearing. Glass prostheses have to be renewed every 1-2 years, while perspex prostheses need to be polished once a year. Complications, such as giant papillary conjunctivitis or blepharoconjunctivitis sicca are facilitated by poor fit, increased age and inappropriate care of the prosthetic device. In the case of socket shrinkage or anophthalmic socket syndrome, surgical interventions are needed to re-enable the use of an artificial eye. CONCLUSION: Adequate fitting, daily care of ocular prosthetics and therapeutic management of associated complications are mandatory for a durable functional, esthetic and psychosomatic rehabilitation after ocular extirpation.
Assuntos
Enucleação Ocular/psicologia , Enucleação Ocular/reabilitação , Olho Artificial/efeitos adversos , Olho Artificial/psicologia , Ajuste de Prótese/métodos , Ajuste de Prótese/psicologia , Análise de Falha de Equipamento , Olho Artificial/tendências , Alemanha , Humanos , Desenho de Prótese/psicologia , Falha de Prótese , Ajuste de Prótese/tendências , Resultado do TratamentoRESUMO
AIMS: To investigate the association of demographic, clinical and psychosocial variables with levels of anxiety and depression in participants wearing an ocular prosthesis after eye enucleation. METHODS: This cross-sectional study included 195 participants with an enucleated eye who were attending an ophthalmic clinic for prosthetic rehabilitation between July and November 2014. Demographic and clinical data, and self-reported feelings of shame, sadness and anger were collected. Participants also completed the National Eye Institute Visual Function Questionnaire, the Facial Appearance subscale of the Negative Physical Self Scale, and the Hospital Anxiety and Depression Scale. Regression models were used to identify the factors associated with anxiety and depression. RESULTS: The proportion of participants with clinical anxiety was 11.8% and clinical depression 13.8%. More anxiety and depression were associated with poorer vision-related quality of life and greater levels of appearance concerns. Younger age was related to greater levels of anxiety. Less educated participants and those feeling more angry about losing an eye are more prone to experience depression. Clinical variables were unrelated to anxiety or depression. CONCLUSIONS: Anxiety and depression are more prevalent in eye-enucleated patients than the general population, which brings up the issues of psychiatric support in these patients. Psychosocial rather than clinical characteristics were associated with anxiety and depression. Longitudinal studies need to be conducted to further elucidate the direction of causality before interventions to improve mood states are developed.
Assuntos
Ansiedade , Depressão , Enucleação Ocular/psicologia , Olho Artificial/psicologia , Qualidade de Vida , Visão Ocular , Adolescente , Adulto , Idoso , Ansiedade/epidemiologia , Ansiedade/psicologia , Estudos Transversais , Depressão/epidemiologia , Depressão/psicologia , Enucleação Ocular/reabilitação , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Perdas oculares provocam assimetria facial e comprometimento estético. As próteses oculares são importantes para restabelecer a estética, proteger a cavidade anoftálmica, restabelecer função, como o redirecionamento do l¡quido lacrimal, e reintegrar o paciente sociedade. O objetivo do trabalho relatar um caso de prótese ocular, demonstrando as etapas clínicas e laboratoriais de sua confecção, destacando as vantagens do uso da mesma. Paciente do sexo feminino foi acometida de toxoplasmose, o que acarretou em perda ocular. Realizou-se a cirurgia de evisceração sendo que a paciente nunca havia utilizado prótese ocular. Dessa forma, foi confeccionada uma prótese ocular em material resinoso PMMA devolvendo a assimetria e estética paciente. A mesma relatou satisfação com a reabilitação protética final. O presente estudo demonstrou que para casos de perda ocular por toxoplasmose, o tratamento com prótese ocular a base de PMMA pode ser uma alternativa segura e satisfatória para restaurar a estética perdida.
Eye loss results on facial asymmetry compromising its aesthetics. Ocular prostheses are important to re-establish aesthetics; protect the anophthalmic cavity; recover function such as the redirection of lachrymatory liquid; and reintegrate the patient to society. The aim of this study was to describe a case report, demonstrating clinical and laboratorial procedures for confection of ocular prostheses and highlighting their advantages. A female patient was afflicted by toxoplasmosis, which led to the loss of her eye. An eye evisceration was performed. The patient reported no previous use of ocular prosthesis. A PMMA ocular prosthesis was manufactured restoring patients aesthetic and facial contour. The patient was satisfied with the treatment. Therefore the present study has shown that PMMA ocular prosthesis is able to restore facial aesthetics and can be a safe and satisfactory alternative for patients that have lost their eyes due to toxoplasmosis
Assuntos
Humanos , Feminino , Adulto , Resinas Acrílicas , Exenteração Orbitária , Olho Artificial/psicologia , Qualidade de Vida/psicologia , Toxoplasmose , Estética/psicologiaRESUMO
OBJECTIVE: Many patients are satisfied with their ocular prosthesis, but some describe problems with social interactions, body image and self-esteem. Although both clinical practice and research suggest that the severity of a disfiguring condition does not predict distress, there has been little research with patients living with an ocular prosthesis. The objective was to explore the psychological impact of living with an artificial eye or cosmetic shell and determine the relationship between psychological well-being and clinical and psychosocial factors. METHODS: A cross-sectional study between March and September 2008 at the ocular prosthesis clinic of Moorfields Eye Hospital, UK. The primary outcome measures were mood as measured by the Hospital Anxiety and Depression Scale (HADS) and appearance-related social anxiety and social avoidance, as measured by the Derriford Appearance Scale (DAS24). RESULTS: Mean scores on the HADS and DAS24 were within normal range, but a considerable proportion of participants were experiencing significant levels of distress. Psychosocial adjustment was unrelated to most clinical and demographic variables, but was associated with a series of cognitive processes. CONCLUSIONS: Psychological variables, rather than clinical or demographic factors, are associated with how a patient adjusts to wearing an ocular prosthesis. Such factors might be amenable to change through psychosocial intervention.
Assuntos
Imagem Corporal/psicologia , Olho Artificial/psicologia , Relações Interpessoais , Implantes Orbitários/psicologia , Autoimagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Transtornos de Ansiedade/psicologia , Estudos Transversais , Transtorno Depressivo/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida/psicologia , Perfil de Impacto da Doença , Inquéritos e Questionários , Adulto JovemRESUMO
The aim of this study was to assess the improvement in psychosocial awareness of anophthalmic patients wearing ocular prostheses and its relationship with demographic characteristics, factors of loss/treatment, social activity, and relationship between professional and patient. Surveys including a form for evaluation of psychosocial pattern were conducted with 40 anophthalmic patients rehabilitated with ocular prosthesis at the Center of Oral Oncology in the authors' dental school from January 1998 to November 2010. The improvement in psychosocial awareness was assessed by comparing the perception of some feelings reported in the period of eye loss and currently. Wilcoxon tests were applied for comparison of patients' perception between the periods. χ(2) tests were used to assess the relationship between the improvement in psychosocial awareness and the variables of the study. In addition, the logistic regression model measured this relationship with the measure of odds ratio. The feelings of shame, shyness, preoccupation with hiding it, sadness, insecurity and fear were significant for improvement in psychosocial awareness. It was concluded that the anophthalmic patients wearing an ocular prosthesis has significant improvement in psychosocial awareness after rehabilitation.
Assuntos
Anoftalmia/reabilitação , Olho Artificial/psicologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ira , Anoftalmia/psicologia , Atitude Frente a Saúde , Criança , Escolaridade , Emoções , Emprego/psicologia , Oftalmopatias/psicologia , Oftalmopatias/reabilitação , Traumatismos Oculares/psicologia , Traumatismos Oculares/reabilitação , Medo , Feminino , Seguimentos , Humanos , Renda , Relações Interpessoais , Masculino , Estado Civil , Pessoa de Meia-Idade , Relações Profissional-Paciente , Qualidade de Vida , Autoimagem , Vergonha , Timidez , Adulto JovemRESUMO
BACKGROUND: The loss of an eye has a crippling effect on the psychology of the patient, making rehabilitation process challenging for both doctor and patient. OBJECTIVE: To report a case of anophthalmic socket with prosthetic rehabilitation in a cost effective manner. CASE: A 32-year-old female presented with anophthalmic socket for prosthetic rehabilitation. A custom made ocular prosthesis was implanted successfully. CONCLUSION: The custom made ocular prosthesis is simple, affordable and can be carried out in a small clinical set-up and provides a superior natural appearance.
Assuntos
Enucleação Ocular/reabilitação , Olho Artificial/psicologia , Satisfação do Paciente , Enucleação Ocular/psicologia , Neoplasias Oculares/reabilitação , Neoplasias Oculares/cirurgia , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
PURPOSE: Anophthalmia is associated with a range of psychosocial difficulties and hydroxyapatite orbital implant insertion and prosthesis wearing is the predominant rehabilitation therapy for anophthalmia. However, few articles have compared preoperative and postoperative psychosocial outcomes using standardized questionnaires. This study aimed to investigate the psychosocial benefits of hydroxyapatite orbital implant insertion and prosthesis wearing in this patient population. METHODS: In all, 36 participants were tested preoperatively and 6-months postoperatively using standardized measures of anxiety and depression (Hospital Anxiety and Depression Scale), social anxiety and social avoidance (Derriford Appearance Scale-Short Form), and quality of life (World Health Organization Quality of Life Scale-Short Form). RESULTS: Before treatment, levels of depression were comparable with population norms; however, levels of general anxiety were slightly raised, levels of social anxiety, social avoidance, and quality of life were significantly poorer than population norms. Treatment resulted in significant improvement in psychosocial adjustment with improvements in all study variables for the participant group as a whole. CONCLUSION: Hydroxyapatite orbital implant insertion and prosthesis wearing offers significant improvements in psychological and physical functioning for patients with anophthalmia.
Assuntos
Anoftalmia/psicologia , Anoftalmia/reabilitação , Materiais Biocompatíveis , Durapatita , Olho Artificial/psicologia , Implantes Orbitários/psicologia , Adolescente , Adulto , Ansiedade/psicologia , Depressão/psicologia , Olho Artificial/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Implantes Orbitários/estatística & dados numéricos , Ajuste de Prótese , Qualidade de Vida/psicologia , Comportamento Social , Inquéritos e Questionários , Adulto JovemAssuntos
Imagem Corporal , Olho Artificial/psicologia , Satisfação do Paciente , Feminino , Humanos , MasculinoRESUMO
UNLABELLED: Facial integrity is a condition which interferes in the daily life of the individual. The loss of an eyeball has psychological impact, requiring adaptation. Interventions such as prosthetic repair seem to lead to emotional and behavioral change. PURPOSE: The objective of this study was to identify the psychosocial aspects related to unilateral anophthalmic socket and evaluate patient adaptation to prosthesis. METHODS: All participants responded to a semi-structured interview. This was composed of two parts, the first regarding the general data of patient identification and socioeconomic aspects. The second part included information about eye loss and rehabilitation, with 31 questions. Twenty-eight volunteers were interviewed. RESULTS: Most were male (53.57%). Ages ranged between 11 and 67. Trauma was the prevalent etiological factor (60.71%). A significant statistical difference (p<0.05) was found between the scores of the feelings of loss before and after prosthesis (z Wilcoxon=-4.41; p<0.001). CONCLUSIONS: The data showed emotional difficulties in the initial contact with the loss of an eye and the role of the prosthesis as an element of social inclusion, stressing the importance of teamwork and access to fitting services in adapting these patients.
Assuntos
Traumatismos Oculares/psicologia , Olho Artificial/psicologia , Adaptação Psicológica , Adolescente , Adulto , Idoso , Criança , Estudos Transversais , Traumatismos Oculares/reabilitação , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Adulto JovemRESUMO
A integridade da face é condição que interfere no cotidiano do indivíduo sendo que a perda do globo ocular tem um impacto psicológico, demandando uma condição de adaptação. Intervenções como a reparação protética parecem produzir mudanças nos âmbitos emocional e comportamental. Objetivo: Identificar os aspectos psicossociais relacionados à ausência unilateral do globo ocular e avaliar a adaptação dos pacientes usuários de prótese ocular. Métodos: Para realização da pesquisa foi utilizado como instrumento de coleta de dados um roteiro de entrevista adaptado aos objetivos desse trabalho. Este foi composto por duas partes, a primeira referente a dados gerais de identificação do paciente e aspectos socioeconômicos. A segunda parte incluiu dados específicos sobre a perda e reabilitação ocular com 31 questões. Vinte e oito pacientes voluntários foram entrevistados. Resultados: A maioria era do gênero masculino (53,57 por cento). A idade variou entre 11 e 67 anos. O trauma foi o fator etiológico prevalente (60,71 por cento). Foi encontrada diferença estaticamente significativa (p<0,05) entre os escores dos sentimentos da época da perda e atualmente (z Wilcoxon=-4,41; p<0,001). Conclusão: Os dados evidenciaram dificuldades emocionais no processo inicial de contato com a condição de perda do olho e o papel da prótese como elemento de inclusão social, ressaltando a relevância do trabalho em equipe e do acesso a serviços de protetização para a adaptação desses pacientes.
Facial integrity is a condition which interferes in the daily life of the individual. The loss of an eyeball has psychological impact, requiring adaptation. Interventions such as prosthetic repair seem to lead to emotional and behavioral change. Purpose: The objective of this study was to identify the psychosocial aspects related to unilateral anophthalmic socket and evaluate patient adaptation to prosthesis. Methods: All participants responded to a semi-structured interview. This was composed of two parts, the first regarding the general data of patient identification and socioeconomic aspects. The second part included information about eye loss and rehabilitation, with 31 questions. Twenty-eight volunteers were interviewed. Results: Most were male (53.57 percent). Ages ranged between 11 and 67. Trauma was the prevalent etiological factor (60.71 percent). A significant statistical difference (p<0.05) was found between the scores of the feelings of loss before and after prosthesis (z Wilcoxon=-4.41; p<0.001). Conclusions: The data showed emotional difficulties in the initial contact with the loss of an eye and the role of the prosthesis as an element of social inclusion, stressing the importance of teamwork and access to fitting services in adapting these patients.
Assuntos
Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Traumatismos Oculares/psicologia , Olho Artificial/psicologia , Adaptação Psicológica , Estudos Transversais , Traumatismos Oculares/reabilitação , Entrevista Psicológica , Fatores SocioeconômicosRESUMO
AIMS: This study aimed to determine the psychosocial and appearance-related concerns of a sample of ophthalmic patients by measuring a range of psychological, social, and demographic factors. METHODS: Standardized psychological measures including anxiety, depression, appearance-related distress, self-discrepancy, appearance salience and valence were administered to 98 participants attending ophthalmic outpatient clinics in either London, Bristol, Sheffield or Bradford. Differences between groups were explored using t-tests and ANOVA, relationships between all variables were investigated using Pearson's correlation coefficient. RESULTS: Although mean scores for psychological adjustment were within the normal range, some participants were experiencing considerable levels of generalized anxiety. Being older, male, and married or living with a partner was related to significantly better adjustment. Better adjustment was also related to a less visible area of concern, greater disguisability of the affected area, a more positive evaluation of their own appearance, less engagement in comparing themselves with others, greater feelings of being accepted by others, appearance being less important to their self-concept, and a smaller discrepancy between the persons ideal and actual appearance. CONCLUSIONS: A majority of ophthalmic patients adjust positively to the demands placed on them. By identifying the variables that are associated with successful adaptation, the specific psychological interventions and appropriate systems of support can be put in place to help those who are adversely affected.
Assuntos
Transtornos de Ansiedade/etiologia , Imagem Corporal , Transtorno Depressivo/etiologia , Oftalmopatias/psicologia , Autoimagem , Estresse Psicológico/etiologia , Adaptação Psicológica , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise de Variância , Aprendizagem da Esquiva , Olho Artificial/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Qualidade de Vida , Adulto JovemRESUMO
PURPOSE: In daily practice, it is often encountered that family and friends prefer the true image of the patient with an ocular prosthesis to the image in the mirror. Hence, when the patient looks at himself in the mirror, he may have the worst image of self. The authors studied the subjective difference between the mirror and true image of patients with an ocular prosthesis. METHODS: Controlled, prospective case series, including 16 patients with an ocular prosthesis and 16 healthy volunteers. The authors designed a double-mirror device that allowed the participant to see both his mirror and unreversed true image and asked the participants which image they preferred. In a slide show with pairs of the original and mirror-reversed photographs of the participants, they were asked which of the 2 photographs of each pair they preferred, of themselves and of the other participants. RESULTS: Of the patients, 100% preferred their mirror image and 79% their mirror-reversed photograph. Of the volunteers, these preferences were 81% and 60%, respectively. The volunteers significantly preferred the photograph of the patients with the ocular prosthesis on their left side. CONCLUSIONS: The patient with an ocular prosthesis prefers his mirror image. While judging unfamiliar faces, the right eye is considered to be more important in the case of abnormality.
Assuntos
Imagem Corporal , Olho Artificial/psicologia , Satisfação do Paciente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fotografação , Estudos Prospectivos , Adulto JovemRESUMO
BACKGROUND: To identify the concerns of experienced artificial eye wearers and investigate whether these had changed since they lost their eye. DESIGN: A retrospective study of private practice patients. PARTICIPANTS: Sixty-three experienced artificial eye wearers. METHODS: An anonymous questionnaire was posted to participants. Paired Wilcoxon tests were used to investigate changes to concern levels over time. Ordinal logistic regression was used to investigate associations of demographic variables with concern levels. MAIN OUTCOME MEASURES: Changes in level of concern over time. RESULTS: At the time of initial eye loss, participants were mainly concerned about the health of their remaining eye, coping with monocularity and receiving good advice. Between initial eye loss and the present, reductions in concern occurred with judging distance, peripheral vision, appearance, receiving good advice, comfort, retention, colour and movement of the artificial eye, fullness of orbit, loss of balance and postoperative pain. Patients whose jobs involved the public were more concerned about appearance and reduced visual range than those in other occupations. Participants' chief present-day concerns were health of the remaining eye and watering, crusting and discharge. All results above had a probability <0.05. CONCLUSIONS: The study emphasized patients' concerns about the health of their remaining eye and their need for good advice at time of eye loss. Knowledge that their initial concerns about judging distance, reduced peripheral vision and appearance all decrease over time may help clinicians in counselling these patients. Watering, crusting and discharge was the chief present-day concern after health of the remaining eye.
Assuntos
Anoftalmia/psicologia , Olho Artificial/psicologia , Qualidade de Vida/psicologia , Atividades Cotidianas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Condução de Veículo , Criança , Bases de Dados Factuais , Avaliação da Deficiência , Feminino , Lateralidade Funcional , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Perfil de Impacto da Doença , Inquéritos e Questionários , Visão Ocular/fisiologiaRESUMO
Maxillofacial prostheses are constructed by maxillofacial prosthetists and technologists (MPTs), as an alternative treatment when maxillofacial defects cannot be surgically fulfilled. A questionnaire was conducted surveying 220 MPTs working in all UK maxillofacial units about their opinions, attitudes, and experience regarding several aspects related to maxillofacial silicone prostheses. Numbers and percentages of maxillofacial prostheses, their retention method, serviceability, reduced serviceability causes, and digital technologies (DT) used in constructing prostheses were analysed. Thousand hundred and ninety-three prostheses were constructed (42% ocular, 31% auricular, 13% orbital, 12% nasal, 1% composite, more than one facial prosthesis). Adhesives commonly retained orbital (48%) and nasal (45%) prostheses. Implant-retained bars commonly retained auricular prostheses (70%). Ocular prostheses were entirely retained by undercuts. Implant-retained prostheses remained serviceable for twice as long (19-24 months) as adhesive-retained prostheses (7-12 months). Causes for prosthesis replacement included colour changes (71%), poor maintenance (41%), and silicone tear (37%). Thirty-one percent of MPTs used DT computer software and programs for designing and constructing maxillofacial prostheses. In conclusion, adhesives, implant-retained bars and magnets are commonly used retentive methods. Prosthesis failure is caused mainly by colour change, poor maintenance, silicone tear and delamination. Different DTs are used by one-third of MPTs.
Assuntos
Atitude do Pessoal de Saúde , Desenho Assistido por Computador , Prótese Maxilofacial/psicologia , Próteses e Implantes/psicologia , Desenho de Prótese , Cimentação , Implantação Dentária Endóssea , Orelha , Olho Artificial/psicologia , Feminino , Humanos , Magnetismo , Masculino , Nariz , Implantes Orbitários/psicologia , Obturadores Palatinos/psicologia , Projetos Piloto , Falha de Prótese , Implantação de Prótese/instrumentação , Implantação de Prótese/métodos , Silicones , Inquéritos e Questionários , Reino UnidoRESUMO
OBJETIVO: Avaliar o perfil biopsicossocial de portadores de anoftalmia, com ênfase no impacto psicológico e funcional da perda ocular e na reintegração social dessa população. MÉTODOS: Realizou-se estudo transversal com 84 pacientes (50 do gênero masculino e 34 do feminino), reabilitados ou em processo de reabilitação com próteses oculares, avaliados por meio de questionário que contemplava dimensões como: etiologia da perda ocular, grau de adaptação à prótese e impacto nas atividades profissionais, sociais e escolares. RESULTADOS: O olho direito foi afetado em 45,2 por cento dos pacientes, o olho esquerdo em 51,2 por cento, e os demais apresentavam anoftalmia bilateral. Relataram dificuldade, atual ou já superada, de adaptação à visão monocular 47,5 por cento dos participantes. No gênero masculino as principais causas da anoftalmia foram os traumatismos oculares por acidentes (54 por cento), e no feminino, as doenças adquiridas (38,2 por cento). Na população estudada, a perda ocular ocorreu, em média, aos 20,5 ± 18,4 anos, e o tempo decorrido até a primeira reabilitação protética foi de 8,6 ± 13,1 anos. A maioria dos pacientes (66,1 por cento) relatou satisfação e boa adaptação à prótese ocular. Sentimentos de tristeza, vergonha e timidez foram freqüentemente relatados. CONCLUSÃO: Pacientes com anoftalmia freqüentemente apresentam transtornos psíquicos e/ou funcionais que dificultam sua readaptação ao meio social, profissional e familiar, o que é agravado por fatores econômicos e pela carência de serviços públicos que ofereçam tratamento reabilitador. A realização de campanhas de esclarecimento à população também pode ser útil para a prevenção das causas que levam à perda ocular.
PURPOSE: To evaluate the biopsychosocial profile of patients with anophthalmia, with emphasis on the psychological and functional impact of eye loss and the social reintegration of this population. METHODS: Prospective analyses of 84 patients (50 males and 34 females), rehabilitated or in the rehabilitation process with ocular prostheses were interviewed by means of a questionnaire with dimensions involving the etiology of the ocular defect, degree of adaptation to the ocular prosthesis, and impact on professional, family and social activities. RESULT: The right eye was affected in 45.2 percent of the patients, the left eye in 51.2 percent, and the rest of the patients had bilateral anophthalmia. Difficulty in adapting to monocular vision was reported by 47.6 percent of the patients. The main causes of anophthalmia in males were eye injuries due to accidents (54 percent), and, in females, acquired diseases (38.2 percent). For the total studied population, the eye loss occurred at a mean of 20.5 ± 18.41 years, and the elapsed time until the first rehabilitation with ocular prosthesis was of 8.6 ± 13.10 years. Most patients (66.1 percent) reported satisfaction and good adaptation to the prosthesis. Feelings of sadness, shame and shyness were frequently reported. CONCLUSION: Anophtalmic patients often exhibit psychic and/or functional disorders which hinder their social, professional and family readaptation, and this is aggravated by both economic factors and lack of public services that provide rehabilitative treatment. Public information campaigns could also be useful to prevent causes that lead to ocular loss.