Prevalence of Meibomian Gland Dysfunction and Its Effect on Quality of Life and Ocular Discomfort in Patients with Prosthetic Eyes

Purpose: To evaluate the influence of ocular discomfort and meibomian gland dysfunction (MGD) on quality of life in patients with an ocular prosthesis. Methods: a prospective analysis was conducted on 18 patients with a unilateral ocular prosthesis. Evaluation of ocular discomfort symptoms, lid margin abnormalities (LMA), meibomian gland expression, meibography and a psychometric evaluation using the National Eye Institute Visual Function Questionnaire (NEI VFQ), Facial Appearance subscale of the Negative Physical Self Scale (NPSS-F), Hospital Anxiety and Depression Scale (HADS) and the DAS24 to evaluate anxiety and depression. Results: the statistically significant differences observed between normal and prosthetic eyes related to ocular symptoms and the meibography score (p = 0.0003). A negative correlation was reported between NEI VFQ score and meibography score (r = 0.509; p-value = 0.022). A positive correlation was detected with NPSS (r = 0.75; p-value < 0.0001), anxiety HADS score (r = 0.912; p-value = 0.001) and depression HADS score (r = 0.870; p-value > 0.0001). Conclusion: MGD represents the most common cause of evaporative dry eye disease, due to the reduction of the thickness of the lipid layer of the tear film. The occurrence of MGD in patients with prosthetic eyes is very common. Anxiety and depression were correlated to ocular discomfort and MGD, and this could affect the quality of life in patients with an ocular prosthesis.