Before they’re fitted with an ocular prosthesis, patients may not be fully aware that certain parts of their eviscerated or even enucleated eye—such as the meibomian glands—remain in operation. These patients can still, and often do, experience discomfort, including dryness, discharge and irritation, and can develop anophthalmic socket infections or glutinous surface deposits. All these discomfort issues are significantly associated with meibomian gland dysfunction (MGD), according to newly published research in Eye & Contact Lens. Furthermore, use of an ocular prosthesis itself can lead to MGD.

Using a 15-item questionnaire, the study evaluated 55 patients who had been wearing a unilateral ocular prosthesis for more than a year. The investigators also evaluated the prosthetic and paired normal eyes with a slit lamp exam, noncontact meibography and OCT. Forty-seven patients underwent evisceration and eight were enucleated. In any patient wearing a prosthetic, though, meibomian gland loss and lid margin abnormality of the prosthetic eyes were significantly higher than those of their normal eyes, the research found. Additionally, the longer patients used an ocular prosthesis, the greater their meibography scores. The length of prosthetic use was also associated with greater meibomian gland loss, lid margin abnormality score and ocular symptoms.

The study shows that patients using a prosthetic eye are at a greater risk of developing ocular dryness and discomfort due to MGD (and that this risk is equal for both the upper and lower eyelid). The investigators recommend these patients be evaluated for MGD and educated on symptoms such as dryness and discomfort.

Ekin, M, Ugurlu S, Kahraman H. Meibomian gland dysfunction and its association with ocular discomfort in patients with ocular prosthesis. Eye Contact Lens. August 20, 2019. [Epub ahead of print].