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Eye (London, England) Aug 2021To report associations with comfort and with appearance satisfaction in artificial eye wearers. (Observational Study)
Observational Study
OBJECTIVES
To report associations with comfort and with appearance satisfaction in artificial eye wearers.
METHODS
Multicentre, observational, cross-sectional study, nationwide within the National Health Service England. The National Artificial Eye Questionnaire (NAEQ) was completed by 951 respondents. Multiple regressions assessed associations between the experiences of artificial eye wearers, routine management, changes over time, baseline and demographic parameters and their reported comfort, satisfaction with appearance and prosthesis motility.
RESULTS
Better comfort levels were associated with needing less lubrication (β = 0.24, p < 0.001), older age (β = 0.17, p = 0.014), less discharge (β = 0.16, p < 0.001), less frequent cleaning (β = 0.16, p = 0.043), and male gender (β = 0.06, p = 0.047). Greater satisfaction with the appearance of the artificial eye was associated with better perceived motility (β = 0.57, p < 0.001). Black ethnic origin predicted a lower satisfaction with the appearance (β = -0.17, p = 0.001). Greater satisfaction with the motility was associated with a better appearance rating (β = 0.51, p < 0.001), longer time of having an artificial eye (β = 0.13, p < 0.001), older age (β = 0.11, p = 0.042), and a shorter adjustment time (β = -0.07, p = 0.016). Of the testimonials concerning appearance aspects, the majority (21/45, 46.7%) were related to the effect on social interactions.
CONCLUSIONS
The results suggest that more attention should be given to the "dry anophthalmic socket syndrome" as a key cause of discomfort. Young patients are concerned particularly about the motility of the artificial eye. Over time satisfaction with the artificial eye movement is likely to improve.
Topics: Aged; Cross-Sectional Studies; Dry Eye Syndromes; Eye, Artificial; Humans; Male; Patient Satisfaction; Personal Satisfaction; State Medicine; Surveys and Questionnaires; United Kingdom
PubMed: 33106611
DOI: 10.1038/s41433-020-01236-9 -
Medicine Jul 2020Anophthalmic patients not only cause obvious functional deficits and facial deformities, but lead to poor psychological outcomes, although prosthesis wearing can offer...
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.
Topics: Adult; Anophthalmos; Anxiety; Case-Control Studies; Cross-Sectional Studies; Depression; Eye, Artificial; Female; Humans; Male; Marital Status; Middle Aged; Risk Factors; Somatoform Disorders; Surveys and Questionnaires; Young Adult
PubMed: 32702931
DOI: 10.1097/MD.0000000000021338 -
Eye (London, England) Jan 2022To report associations with visual function and quality of life (QOL) in artificial eye wearers. (Observational Study)
Observational Study
OBJECTIVES
To report associations with visual function and quality of life (QOL) in artificial eye wearers.
METHODS
Multicentre, observational, cross-sectional, nationwide study, within the National Health Service England. Items were adopted from the National Eye Institute Visual Function Questionnaire, and incorporated in the National Artificial Eye Questionnaire (NAEQ). The NAEQ was completed by 951 respondents. Multiple regressions assessed associations between the QOL scores and the experiences of artificial eye wearers, their routine management, changes over time, baseline and demographic parameters.
RESULTS
Parameters predictive of a better QOL composite score included longer artificial eye wear (β = 0.18, p < 0.001), better appearance (β = 0.17, p < 0.001), better comfort (β = 0.14, p = 0.001), tumour-related anophthalmia (β = 0.13, p = 0.003), male gender (β = 0.13, p < 0.001), shorter period of adjustment to monocular vision (β = 0.12, p < 0.001) and use of soap for cleaning (β = 0.09, p = 0.046). The composite score continued to improve beyond 10 years of prosthesis wear (≤2 years mean 72.80 ± 1.65 versus >10 years mean 79.45 ± 0.70; p = 0.001). Both better prosthesis appearance (β = 0.14, p = 0.022) and improved motility (β = 0.13, p = 0.042) predicted a better dependency score. Use of lubricating ointment predicted a worse dependency score (β = 0.23, p = 0.003). Neither the frequency of removal, nor the cleaning frequency of the artificial eye correlated with QOL scales.
CONCLUSIONS
Multiple factors in the artificial eye experience were found to predict visual function and QOL aspects. This study underscores the need to generate a dedicated QOL questionnaire for use in anophthalmic patients.
Topics: Anophthalmos; Cross-Sectional Studies; Eye, Artificial; Humans; Male; Quality of Life; State Medicine; Surveys and Questionnaires; United Kingdom
PubMed: 33649575
DOI: 10.1038/s41433-021-01459-4 -
Journal of Indian Prosthodontic Society 2023The disfigurement associated due to the loss of an eye can cause a significant physical and psychological disturbance. Psychological distress among such unfortunate... (Review)
Review
The disfigurement associated due to the loss of an eye can cause a significant physical and psychological disturbance. Psychological distress among such unfortunate patients can be reduced by providing an artificial eye. Rehabilitating such patients with an ocular defects is the most challenging task for a prosthodontist. The custom-made ocular prostheses are preferred over the prefabricated stock eye shells as it provides intimate contact with the tissue bed, enabling an ideal fit. For an esthetic ocular prosthesis, the precise positioning of an iris is a primary requirement to avoid the squint eye appearance. Various case reports are documented in the literature for centralizing the iris in the prosthetic eye. This review article explores the established methods and techniques for positioning the iris in a custom-made ocular prosthesis.
Topics: Humans; Prosthesis Design; Eye, Artificial; Esthetics, Dental; Iris; Face; Iris Plant
PubMed: 36588369
DOI: 10.4103/jips.jips_252_22 -
Clinical Ophthalmology (Auckland, N.Z.) 2021To assess the biometry and postoperative refraction in iris repair using ArtificialIris in combination with an intraocular lens (IOL).
PURPOSE
To assess the biometry and postoperative refraction in iris repair using ArtificialIris in combination with an intraocular lens (IOL).
SETTING
Department of Ophthalmology, University Hospital Heidelberg, University of Heidelberg, Germany.
DESIGN
Retrospective observational study.
METHODS
We included 44 aniridic and aphakic eyes for IOL implantation in combination with iris prosthesis reconstruction. The iris prostheses were either sutured into the ciliary sulcus and fixed by transscleral suturing or were implanted together with a capsular tension ring and the IOL in the capsular bag. The primary outcomes measured were pre- and postoperative best corrected visual acuity (CDVA), objective and subjective refraction, anterior chamber depth and optical biometry comparing common IOL formulae.
RESULTS
Reasons for surgery were trauma (39 eyes), iatrogenic causes (1 eye), aniridic state after severe iritis (2 eyes) or iris tumor (2 eyes). Monocular CDVA improved significantly (p<0.0001) from median 0.55 logMAR (0.0 to 1.98) to 0.16 logMAR (-0.08 to 2.0). There were no significant differences between the postoperative target refraction calculated by the formulae "Haigis", "Hoffer-Q", "SRK/T" and "Holladay 1" (p=0.68). The absolute deviation from target refraction did not differ significantly between the formulae (p=0.87). Median target refraction was -0.42 D (-4.0 to 1.68). Postoperatively median spherical equivalent was 0.00 D (-5.38 to 2.38). Median absolute deviation from target refraction after 5 months of follow-up was 0.98 D (0.06 to 5.17).
CONCLUSION
Postoperative refraction using common techniques and using preoperative biometry revealed a well predictable postoperative refraction. There is no correction factor needed.
PubMed: 33658755
DOI: 10.2147/OPTH.S302224 -
Journal of Neuroengineering and... Apr 2023Advanced upper limb prostheses aim to restore coordinated hand and arm function. However, this objective can be difficult to quantify as coordinated movements require an... (Review)
Review
Advanced upper limb prostheses aim to restore coordinated hand and arm function. However, this objective can be difficult to quantify as coordinated movements require an intact visuomotor system. Eye tracking has recently been applied to study the visuomotor behaviours of upper limb prosthesis users by enabling the calculation of eye movement metrics. This scoping review aims to characterize the visuomotor behaviours of upper limb prosthesis users as described by eye tracking metrics, to summarize the eye tracking metrics used to describe prosthetic behaviour, and to identify gaps in the literature and potential areas for future research. A review of the literature was performed to identify articles that reported eye tracking metrics to evaluate the visual behaviours of individuals using an upper limb prosthesis. Data on the level of amputation, type of prosthetic device, type of eye tracker, primary eye metrics, secondary outcome metrics, experimental task, aims, and key findings were extracted. Seventeen studies were included in this scoping review. A consistently reported finding is that prosthesis users have a characteristic visuomotor behaviour that differs from that of individuals with intact arm function. Visual attention has been reported to be directed more towards the hand and less towards the target during object manipulation tasks. A gaze switching strategy and delay to disengage gaze from the current target has also been reported. Differences in the type of prosthetic device and experimental task have revealed some distinct gaze behaviours. Control factors have been shown to be related to gaze behaviour, while sensory feedback and training interventions have been demonstrated to reduce the visual attention associated with prosthesis use. Eye tracking metrics have also been used to assess the cognitive load and sense of agency of prosthesis users. Overall, there is evidence that eye tracking is an effective tool to quantitatively assess the visuomotor behaviour of prosthesis users and the recorded eye metrics are sensitive to change in response to various factors. Additional studies are needed to validate the eye metrics used to assess cognitive load and sense of agency in upper limb prosthesis users.
Topics: Humans; Artificial Limbs; Eye-Tracking Technology; Benchmarking; Upper Extremity; Hand; Prosthesis Design
PubMed: 37095489
DOI: 10.1186/s12984-023-01180-1 -
American Journal of Ophthalmology Aug 2021This study aims to improve the apparent motility of ocular prosthetic devices using technology. Prevailing ocular prostheses are acrylic shells with a static eye image...
PURPOSE
This study aims to improve the apparent motility of ocular prosthetic devices using technology. Prevailing ocular prostheses are acrylic shells with a static eye image rendered on the convex surface. A limited range of ocular prosthetic movement and lack of natural saccadic movements commonly causes the appearance of eye misalignment that may be disfiguring. Digital screens and computational systems may obviate current limitations in eye prosthetic motility and help prosthetic wearers feel less self-conscious about their appearance.
METHODS
We applied convoluted neural networks (CNNs) to track pupil location in various conditions. These algorithms were coupled to a microscreen digital prosthetic eye (DPE) prototype to assess the ability of the system to capture full ocular ductions and saccadic movements in a miniaturized, portable, and wearable system.
RESULTS
The CNNs captured pupil location with high accuracy. Pupil location data were transmitted to a miniature screen ocular prosthetic prototype that displayed a dynamic contralateral eye image. The transmission achieved a full range of ocular ductions and with grossly undetectable latency. Lack of iris and sclera color and detail, as well as constraints in luminosity, dimensionality and image stability limited the real eye appearance. Yet, the digitally rendered eye moved in the same amplitude and velocity as the native, tracked eye.
CONCLUSIONS
Real-time image processing using CNNs coupled to microcameras and a miniscreen DPE may offer improvements in amplitude and velocity of apparent prosthetic eye movement. These developments, along with ocular image precision, may offer a next-generation eye prosthesis. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
Topics: Algorithms; Consensus; Eye Diseases; Eye Movements; Eye, Artificial; Humans; Image Processing, Computer-Assisted; Iris; Ophthalmology; Pupil; Societies, Medical; United States; Vision, Ocular
PubMed: 33852909
DOI: 10.1016/j.ajo.2021.03.025 -
Biomedical Optics Express Feb 2024Adaptive optics visual simulation is a powerful tool for vision testing and evaluation. However, the existing instruments either have fixed tabletop configurations or,...
Adaptive optics visual simulation is a powerful tool for vision testing and evaluation. However, the existing instruments either have fixed tabletop configurations or, being wearable, only offer the correction of defocus. This paper proposes a novel head-mounted adaptive optics visual simulator that can measure and modify complex ocular aberrations in real-time. The prototype is composed of two optical modules, one for the objective assessment of aberrations and the second for wavefront modulation, all of which are integrated into a wearable headset. The device incorporates a microdisplay for stimulus generation, a liquid crystal on silicon (LCoS) spatial light modulator for wavefront manipulation, and a Hartmann-Shack wavefront sensor. Miniature optical components and optical path folding structures, together with in-house 3D printed mounts and housing, were adapted to realize the compact size. The system was calibrated by characterizing and compensating the internal aberrations of the visual relay. The performance of the prototype was analyzed by evaluating the measurement and compensation of low-order and higher-order aberrations induced through trial lenses and phase masks in an artificial eye. The defocus curves for a simulated bifocal diffractive lens were evaluated in real eyes. The results show high accuracy while measuring and compensating for the induced defocus, astigmatism, and higher-order aberrations, whereas the MTF analysis shows post-correction resolution of up to 37.5 cycles/degree (VA 1.25). Moreover, the subjective test results show the defocus curves closely matched to a commercial desktop visual simulator.
PubMed: 38404335
DOI: 10.1364/BOE.506858 -
The British Journal of Ophthalmology Aug 1987We report on 15 patients (10 boys, 5 girls) with clinical anophthalmos. Two of them had bilateral anophthalmos, 10 had systemic anomalies, and six had abnormalities of...
We report on 15 patients (10 boys, 5 girls) with clinical anophthalmos. Two of them had bilateral anophthalmos, 10 had systemic anomalies, and six had abnormalities of their remaining eye. Only two appeared to have an associated underlying aetiology. Fourteen patients underwent orbital reconstruction or socket enlargement with varying degrees of success. Our own experience suggests that unnecessary lid procedures should be avoided, but we recommend early prosthetic fittings. We feel that a multidisciplinary approach is necessary to attain useful rehabilitation.
Topics: Anophthalmos; Eye, Artificial; Female; Humans; Male; Orbit; Surgery, Plastic
PubMed: 3651379
DOI: 10.1136/bjo.71.8.635 -
Optics Express Apr 2020The impact of the intraocular straylight (IOS) on the visual performance and retinal imaging is still a challenging topic. Direct optical methods to measure IOS avoid...
The impact of the intraocular straylight (IOS) on the visual performance and retinal imaging is still a challenging topic. Direct optical methods to measure IOS avoid psychophysical approaches and interaction with the patient. In this work, we developed an optical instrument providing direct imaging measurement of IOS based on the double-pass technology. The system was tested in an artificial eye IOS model constructed with holographic diffusers and validated with theoretical simulations.
Topics: Equipment Design; Eye, Artificial; Glare; Humans; Retina; Visual Field Tests
PubMed: 32403638
DOI: 10.1364/OE.387940