Mucoid Discharge Research Articles

Midline cervical cleft: a case report

A 14-year-old boy presented with complaints of a sinus in the middle of neck, with mucoid discharge present since birth. MRI sinogram along with MRI neck was taken which revealed a sinus tract opening in midline, extending posteriorly and traversing inferiorly to end blindly above sternum. Patient was planned for an elective excision of sinus tract, with z-plasty for decreased scarring. Congenital midline cervical cleft is a rare entity that was first described in 1924. Subsequently there have been fewer than 100 cases reported in medical literature. It typically manifests at birth as a cleft at level of suprasternal notch with a pseudonipple above it. Pathogenesis of congenital midline cervical clefts remains speculative. Differential diagnosis includes thyroglossal duct cysts or branchial cleft anomalies.

Congenital Lacrimal Fistula in a Seven-Year-Old Female: A Rare Cause of Epiphora

Congenital lacrimal fistulas are rare epithelium-lined tracts that tend to have a direct communication between skin and the lacrimal drainage system. These are benign developmental abnormalities, that may require no treatment. This is a rare diagnosis since patients are usually asymptomatic and presents only when epiphora is associated. When symptomatic, congenital lacrimal fistula presents as epiphora, or mucoid discharge, rarely patients could develop nasolacrimal duct obstruction, which may present as recurrent dacryocystitis. Thorough clinical examination is the best way to diagnose the condition, where a fistula ostium may be found inferonasal to medial canthus of the eye. Further, lacrimal probing and irrigation is helpful. Surgical management of the fistula is advised only if the disease is symptomatic which ranges from simple excision to dacryocystorhinostomy. This is a report of one such patient with congenital lacrimal fistula which was treated surgically by fistulectomy.

Low-dose macrolides for treating pediatric rhinosinusitis: A retrospective study and literature review.

The effects of low-dose macrolide (LDM) therapy on pediatric chronic rhinosinusitis (CRS) patients are unknown. This study aimed to assess the effectiveness of LDM for treating pediatric refractory CRS. A retrospective study was conducted by a medical chart review. Pediatric CRS patients (age <15 years) who received LDM after standard medical treatments failure between 2013 and 2019 were identified. The LDM treatments with any macrolide agents, doses, and regimens were included. Any co-interventions were allowed. Duration of the LDM therapy was ≥6 weeks. Outcomes were the total nasal symptoms by the visual analogue scale (TNS), presence of individual symptoms, physician-assessment nasal discharge and adverse events. Six patients (67% male, mean age 7±3.4 years) were assessed. All patients had failed to intranasal steroids and nasal saline irrigation but continued. The addition of LDM significantly improved TNS (mean difference ± standard deviation 5.83 ± 1.33; 95% confidence interval 4.44–7.23, p< 0.001). At the end of treatment, the numbers of patients with individual symptoms were decreased: nasal obstruction (100%–67%), rhinorrhea (83%–50%), hyposmia (50%–0%), cough (100%–33%), and physician-assessment thick mucoid discharge (33%–0%). No patients had facial pain. One patient reported mild tolerable nausea. Preliminary findings of this study showed some beneficial effects of LDM added to intranasal steroids and nasal saline irrigation in pediatric CRS after standard treatments failure. The beneficial effects included the improvements of the TNS and individual nasal symptoms and decrease in thick mucoid discharge.

Osteoma of maxillary sinus: A rare cause of epiphora

Osteomas are fibro-osseous lesions of the nose and paranasal sinuses. We report a case of a 14-year-old girl who presented with complaints of left-sided epiphora along with intermittent mucoid discharge for 6 months. Based on the clinical diagnosis of left nasolacrimal duct obstruction, radiological investigations were done which reported as an osteoma of the left maxillary sinus, compressing the nasolacrimal duct. The patient underwent conventional dacryocystorhinostomy and the tumor was removed. To the best of our knowledge, acquired nasolacrimal duct obstruction due to an osteoma of maxillary sinus is a rare presentation and has been reported only in few literatures.

External dacryocystorhinostomy in patients with granulomatous polyangiitis.

To review the outcome for primary or revisional external dacryocystorhinostomy in patients with granulomatous polyangiitis. Retrospective case-note review to include age at presentation, duration of prior GPA, immunosuppression at time of surgery, nature of first lacrimal surgery, and symptomatic control. Forty-eight patients (25 female; 52%) presented at an average age of 50.5 years and 7 (15%) had prior lacrimal surgery on one (5/7; 71%) or both sides. The duration of systemic GPA varied, with 40% having disease for up to 3 years prior to lacrimal referral, and 41/48 (85%) being on systemic immunosuppression. Forty-eight patients had 71 affected drainage pathways-having symptoms for an average of 22 months (range <1 month to 7 years). Surgery was undertaken on 70/71 systems-62/70 primary DCRs (20 unilateral; 8 simultaneous bilateral; 13 sequential bilateral). Of nine systems with persistent symptoms after prior surgery, eight underwent revisional surgery (six unilateral; one sequential bilateral). With a follow-up of 2.5 years (range 3 months to 14 years), volume symptoms were cured in all 70 cases. Flow symptoms were controlled in 58/62 (94%) systems after primary DCR, and all eight after revisional surgery. Of four sides with persistent epiphora, one was cured with revisional DCR and three with placement of Jones' canalicular bypass tubes. Mucoid discharge, dacryocystitis and recurrent conjunctivitis were cured in all patients with GPA after either primary and revisional surgery. Continued epiphora was controlled in most patients with additional closed procedures.

1895 “The First Burn Is the Deepest:” A Cautionary Tale in Superficial APC Therapy for Radiation Proctopathy

INTRODUCTION: Globally, prostate cancer is the most commonly diagnosed cancer in men. Radiation therapy remains a mainstay in the armamentarium in the treatment of this disease. Radiation proctopathy is a common side effect of this treatment modality with an incidence in patients treated with brachytherapy alone estimated to range from 8 to 13%, and up to 21% in combination with other modalities [2]. Radiation proctopathy typically presents with diarrhea, mucoid discharge, urgency, tenesmus, and bleeding. Argon plasma coagulation (APC) has become the primary therapeutic modality in the management of radiation injury. It is essential that physicians of all specialties (as well as others who care for these patients) be aware of the multiple complications of this therapy. More severe adverse events, notably rectal ulcers following APC therapy are not uncommon, with an incidence ranging from 3 to 16%. CASE DESCRIPTION/METHODS: A 67-year-old man with a history of prostate cancer treated with radiation therapy one year prior presented with intermittent rectal bleeding for one and a half months. A colonoscopy was performed, which revealed a small area near the dentate line characterized by slightly oozing neovascularized tissue consistent with radiation proctopathy. This area was treated with APC with good effect. Biopsies of this area revealed hyperplastic crypts, lamina propria fibrosis, and vascular ectasias compatible with radiation injury. Three months following treatment, the patient developed recurrent rectal bleeding. A flexible sigmoidoscopy revealed a deep non-bleeding ulcer in the rectum. Subsequent CT enterography and MRI of the pelvis demonstrated a deep rectal ulcer with abutment of a 1.5cm peri-prostatic abscess. The patient was followed closely over the next several months in concert with colorectal surgical colleagues, with serial imaging and subsequent resolution of the peri-prostatic abscess as well as cessation of rectal bleeding. DISCUSSION: As more patients with prostate cancer are treated with radiation therapy the incidence of radiation proctopathy is increasing. Although argon plasma coagulation has been shown to be an effective therapy for this issue, providers must consider and discuss with patients the potential complications of this otherwise effective and generally well-tolerated mode of treatment.

Cryolite glass prosthetic eyes—the response of the anophthalmic socket

To investigate mucoid discharge and the inflammatory response of anophthalmic sockets to cryolite glass prosthetic eye wear. A total of 101 cryolite glass prosthetic eye wearers used visual analog scales (0-10) to measure frequency, color, volume, and viscosity of mucoid discharge associated with their prosthesis. Standardized photographs of the conjunctiva of their anophthalmic sockets were taken and conjunctival inflammation was semi-quantitatively graded (0-4). All characteristics of discharge and conjunctival inflammation were correlated to eye loss cause, hand washing behavior, and cleaning regimes as explanatory variables. Mean mucoid discharge characteristics (0-10 scale) were frequency 5.3 ± 2.8, color 4.8 ± 3.2, volume 4.9 ± 3.0, and viscosity 5.1 ± 3.2. The mean conjunctival inflammation score (0-4 scale) was 2.1 ± 1.0. There was a positive correlation between the grade of conjunctival inflammation and the frequency (p = 0.018), color (p = 0.001), volume (p = 0.003), and the viscosity of mucoid discharge (p = 0.005). More conjunctival inflammation was associated with higher frequency of cleaning (p < 0.001) and lower frequency of hand washing before removal (p = 0.001). Higher frequency, color, volume, and viscosity of discharge were associated with higher frequency of cleaning (p ≤ 0.001). Discharge severity associated with prosthetic eye wear was positively correlated with more conjunctival inflammation, higher cleaning frequency, and less hand washing before handling. The results suggest that cryolite glass eyes should not be removed daily for cleaning and that further research should be undertaken to develop a standardized treatment protocol for managing inflammation and mucoid discharge. This protocol would advise hand washing before handling cryolite glass eyes and recommend a minimum period of wear between cleaning sessions.

“ Effect of Apamarga Kshara Pratisarana followed by Jatyadi Tail Pichu on Cervical Erosion - A Case study ”

Since evolution of life,woman has been placed on extreme worship place due to her ability of Janan. Preparation of motherhood starts with puberty &amp; ends with menopause. In this period,woman may suffer from different gynaecological disorders affecting child bearing capacity. Cervical erosion is one of the gynaecological conditions in woman of reproductive age group. It adversely affects physiological as well as psychological health of female &amp; even interfers with the professional life &amp; may also cause infertility. So, it is major problem in front of gynaecologists.&#x0D; Cervical erosion is a condition, where the squamous epithelium of the ectocervix is replaced by columnar epithelium. It causes excessive mucoid discharge per vagina. Electrocauterization &amp; cryosurgery for management of cervical erosion are based on principle of destruction of columnar epithelium to be followed by it’s healing by squamous epithelium.&#x0D; Ayurvedic classics defined use of Shodhana dravyas in treatment of Karnini Yonivyapada. Many preparations can be used for management of cervical erosion by considering factors such as parity, age &amp; desire of patient with regard to contraception, future pregnancy etc. which are non-hormonal, non-surgical &amp; most effective without side effects. Among these, Apamarga Kshara for destruction &amp; Jatyadi Tail Pichu for healing was selected in the present study.

A Clinical Masquerader: Squamous Cell Carcinoma of the Eyelid Previously Diagnosed as an Eye Bump

Malignant eyelid tumors are often difficult to diagnose at early stage growth, and can be clinically challenging. Due to the high prevalence of periocular skin cancers, clinicians must be very attentive in their assessment of skin lesions amongst their patients. This case report highlights an early non-healing eyelid lesion transforming into squamous cell carcinoma. An 83-year-old male with no history of malignancy presented with a non-healing and rapidly growing lesion of the left lower eyelid. He first noticed this lesion one-month prior and was treated with oral antibiotics without improvement by his primary care provider. Our slit lamp examination of the left eyelid revealed a large ulcerated mass with white mucoid discharge draining from the center of the lesion. After an oculoplastics referral, the patient was diagnosed with squamous cell carcinoma confirmed by biopsy. Computed tomography(CT) showed no metastasis or invasion to deep layer tissue. The management decision in this case required exenteration of the left eye socket followed by radiation therapy. This case illustrates the clinical course and invasive nature of periocular squamous cell carcinoma. It can present in a variety of different appearances, but are mostly painless, hyperkeratotic lesions that progressively change and ulcerate. An extensive history and careful clinical examination are vital in order to detect malignancy in a timely manner.

MOLECULAR CHARACTERIZATION OF SOME VIRULENCE GENES IN KLEBSIELLA PNEUMONIAE ISOLATED FROM BROILERS

In the present study, a total of 160 samples (lung, air sacs, liver and kidneys, 40 samples each) were collected from clinically diseased broiler chickens. Clinical signs were weakness, gasping, ruffled feather, nasal mucoid discharge, poor growth, facial oedema and conjunctivitis, while postmortem findings were signs of septicemia, pneumonia, air sacculitis, nephritis, sinusitis and liver and lung abscesses. Isolation and biochemical identification of K. pneumoniae were done. Results of bacteriological examination revealed that K. pneumoniae isolates were recovered from 160 samples with overall prevalence (14.4%). The isolation rates from lung, air sacs, liver and kidneys were 30 %, 12.5%, 10% and 5%, respectively. The isolates of K. pneumoniae were found to be virulent by using PCR assay incorporating magA, fimH and traT genes primers and were found to be resistant to some antibiotics by using PCR assay incorporating tetA(A), blaTEM and mphA genes primers. Antibiogram for 20 recovered K. pneumoniae isolates against 10 commercially used antibiotics in broiler chicken farms revealed that K. pneumoniae isolates were completey resistant to oxytetracycline (100%) and ampicillin (100%) followed by erythromycin (90%), streptomycin (80%), cefotaxim (70%) and gentamycin (65%) and moderate resistance to neomycin (45%) and chloramphenicol (30%). On the

Outcome of External Dacryocystorhinostomy and Monocanalicular Intubation in Patients with Total Obstruction of One Canalicus.

PurposeWe sought to evaluate the outcomes of external dacryocystorhinostomy (DCR) and mono-canalicular intubation in patients with total obstruction of one canalicus.MethodsSixteen eyes of 16 patients with nasolacrimal duct obstruction and a single canaliculus obstruction who had undergone external DCR and monocanalicular intubation of the intact canaliculus were retrospectively included in the present study. The monocanalicular tube (Mini Monoka) was left in place for at least two months. Munk epiphora grading for the evaluation of epiphora and irrigation was performed both preoperatively and at 6 months postoperatively.ResultsMean patient age was 46 ± 14.2 (range, 18 to 76) years. The inferior canaliculus was obstructed in nine eyes (group A) and the superior canaliculus was obstructed in seven eyes (group B), respectively. Eight eyes had chronic dacryocystitis and two of these eyes also had a history of acute dacryocystitis attack. Mean preoperative Munk scores were 3.89 in group A and 4.0 in group B. Ocular surface irritation occurred in one eye in group A. Artificial eye drops were prescribed and early tube removal was not performed. Spontaneous tube dislocation was recorded in one eye in group B. No other corneal, punctal, or canalicular complications were found. At six months, irrigation of intact canaliculus was patent in all eyes. Mucoid discharge, conjunctival hyperemia, and chronic conjunctivitis were also resolved. Postoperative Munk scores were 1.11 ± 0.9 in group A and 0.86 ± 0.9 in group B. Of note, preoperative and postoperative Munk scores were significantly different in both groups (group A, p = 0.006; group B, p = 0.017). The postoperative Munk scores were not statistically different between the two groups (p = 0.606).ConclusionsIn patients with nasolacrimal duct obstruction and a total of one canaliculus obstruction, external DCR and monocanalicular intubation of the intact canaliculus is an effective surgical option.

External Congenital Lacrimal Sac Fistula: А Case Report

Abstract Congenital lacrimal fistula is a developmental abnormality. This is a case of a patient with an external congenital lacrimal sac fistula. Surgical treatment was used to correct the condition. Immediate postoperative results were seen. To present a case of a patient with an external congenital lacrimal sac fistula, in which surgical treatment was applied and immediate postoperative results with a good outcome were seen. A 3-year-old boy with an external congenital lacrimal sac fistula presented to our clinic. The skin orifice was observed on the left eye in a typical place – located in the inferomedial aspect of the medial canthal angle. The patient was treated in the at the Eye clinic, at university hospital “Dr. Georgi Stranski” – Pleven, Bulgaria. He underwent a surgical procedure – simple fistula excision (closed fistula excision). The surgical technique was a successful closed fistula excision. In the immediate postoperative period there were no complications such as infection, recurrence or worsening of the epiphora, poor cosmetic results, bleeding or damage to the lid structures or nose. The prognosis for patients with congenital lacrimal fistulas is quite good. Many are asymptomatic and those who have symptomatic epiphora or mucoid discharge can be successfully treated by surgery. Several surgical options exist – closed fistula excision, dacryocystorhinostomy (DCR) with fistula excision and fistula excision with nasolacrimal intubation. Symptomatic congenital lacrimal sac fistulas can be treated successfully with excision alone.

An Emergent Entity: Indolent Mucormycosis of the Paranasal Sinuses. A Multicenter Study.

Introduction Indolent or chronic mucormycosis is a rare entity that affects both immunosuppressed and immunocompetent individuals. Additionally, its clinical evolution is nonspecific and there is no standardized treatment for this condition. Objective To describe the clinical characteristics and management of patients with indolent mucormycosis. Methods In the project of study with chart review in the Interinstitutional secondary care centers, patients with evidence of indolent mucormycosis, defined as pathological confirmation of nasal/paranasal sinus mucormycosis for more than 1 month, were included. All patients underwent complete laboratory workup, imaging studies, surgical treatment and adequate follow-up. No evidence of disease status was defined when patient had subsequent biopsies with no evidence of mucormycosis. Results We included seven patients, three female and four male subjects. The mean age was 53.14 years. Four patients were immunosuppressed and three immunocompetent. Among the immunosuppressed patients three had diabetes and one had dermatomyositis. The symptoms were nonspecific: facial pain/headache, mucoid discharge and cacosmia were the ones most frequently reported. Maxillary sinus involvement was present in all patients. Two immunosuppressed subjects received amphotericin. Posaconazole was the only treatment in one immunosuppressed patient. All immunocompetent patients had single paranasal sinus disease and received only surgical treatment. All patients are alive and free of disease. Conclusion Indolent mucormycosis is a new and emerging clinical entity in immunosuppressed and immunocompetent patients. Single paranasal sinus disease is a frequent presentation and should not be overlooked as a differential diagnosis in these patients. Immunocompetent patients should only be treated surgically.

Congenital Nasolacrimal Duct Obstruction (CNLDO): A Review.

Congenital nasolacrimal duct obstruction (CNLDO) is a common condition causing excessive tearing or mucoid discharge from the eyes, due to blockage of the nasolacrimal duct system. Nasolacrimal duct obstruction affects as many as 20% children aged <1 year worldwide and is often resolved without surgery. Available treatment options are conservative therapy, including observation, lacrimal sac massage and antibiotics, and invasive therapy. Observation, combined with conservative options, seems to be the best option in infants aged <1 year. Meanwhile, in children aged >1 year, nasolacrimal probing successfully addresses most obstructions. However, the most favorable timing for probing remains controversial. To alleviate persistent epiphora and mucous drainage that is refractory to probing, repeat probing, silicone tube intubation, balloon catheter dilation or dacryocystorhinostomy can be considered as available treatment options. Our review aims to provide an update to CNDO management protocols.

Branchial Cyst with Branchial Fistula: A Rare Association.

Branchial arch anomalies are the most common congenital neck masses. The second branchial arch anomalies followed by first arch anomalies are seen commonly in the descending order. They originate from remnants of branchial arches and clefts. They may present as cysts, sinus tracts, fistulae or cartilaginous remnants. They are mostly located in the lateral aspect of the neck anterior to the sternocleidomastoid, anterior to the hyoid bone, preauricular region or at the angle of the mandible. A complete fistula communicating with a branchial arch cyst is a very rare congenital anomaly of the branchial apparatus. These patients are generally asymptomatic but may present with mucoid discharge from the tract. Here we present a case of branchial fistula associated with a branchial cyst in a 11year old child.

Down the ear

A basic knowledge of the normal architecture of the external and middle ear of the cat and dog is important in the investigation and diagnosis of ear disease in these species. The appearance of the canal is very different in cases where infection is present with yeast where the canal may be hyperplastic and contain a thick ceruminous discharge compared to that with infections such as Pseudomonas spp. where the canal is ulcerated, swollen and contains a malodorous green-yellow mucoid discharge. The appearance of the canal together with cytology can help in the selection of ear cleaners and drops.

Primary fistulectomy of congenital lacrimal fistula: A case report

A 13-month-old male patient presenting with epiphora and discharge in his left eye present since birth was assessed in our clinic. Epiphora and an orifice of fistulae next to the left nasal root were identified via physical examination. Punctual mucoid discharge was observed following a massage of the left lacrimal sac. Chronic lacrimal fistulae were diagnosed in terms of stain outflow from the fistula orifice following a trypan blue injection to the lacrimal sac under general anesthesia. The patency of the distal nasolacrimal duct was confirmed by performing lavage following the fistulectomy procedure. The epiphora disappeared and the nasolacrimal passage was open in post-operative care.

A study of surgical outcomes of myringoplasty in active and inactive ears

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Chronic otitis media (COM) can present with inactive (dry) and active (wet) ear. It’s an accepted fact that an actively draining central perforation is not a contraindication for ear surgery. The discharging ear presents the otologists with the dilemma of operating on it or not, this is due to widespread belief that the success rate while doing ear surgeries on active ears is decidedly inferior. Hence the present study is intended to find the outcome of ear surgeries in inactive and active ear with objective to find the incidence of graft uptake and hearing improvement in both the groups.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 50 active ear (with mucoid discharge) and 52 inactive ears (not discharging at least 3 month before surgery) with mucosal chronic otitis media underwent myringoplasty with cortical mastoidectomy. Graft take and hearing gain rates 3 and 6 months after surgery were calculated for both groups and compared. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The graft take rate was 90% for the active ear group and 94% for the inactive ear group. The hearing gain rate was 90% for the active ear group and 94% for the inactive ear group. Differences were found to be statistically insignificant for both graft intake (p=0.461) and hearing gain (p=0.543).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The success of myringoplasty is not adversely affected by the presence of mucoid ear discharge at time of surgery, and outcomes are comparable to those of the opration done for inactive ears. &lt;/p&gt;

Bacteriological study and antibiotic sensitivity profile in patients with ear discharge visiting ENT OPD at tertiary care center

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Otitis media (OM) is a big menace in countries like India. Chronic suppurative otitis media (CSOM) is chronic inflammation of middle ear, which affects the tympanic membrane, middle ear mucosa and other middle ear structures characterised by the presence of persistent perforation or persistent mucoid or muco-purulent discharge for at least 8 weeks. Variety of organisms founds in patients suffering from chronic otitis media like, &lt;em&gt;Pseudomonas&lt;/em&gt;, &lt;em&gt;Staphylococcus aureus&lt;/em&gt;, &lt;em&gt;Proteus mirabilis&lt;/em&gt;, &lt;em&gt;Klebsiella pneumonia&lt;/em&gt; and &lt;em&gt;Escherichia coli&lt;/em&gt; found. The pattern of organisms varies in different geographical areas. The objectives of the study were to isolate bacteria from patients with ear discharge, to find out antibiotic sensitivity of isolated organisms&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;This is an observational cross sectional study done in the OPD department of otorhinolaryngology, at P.D.U medical college and hospital, Rajkot, for a period of six months from January 2017 to June 2017. A total number 200 patients of both gender between 5 to 74 years who visited the OPD department of otorhinolaryngology with chronic ear discharge taken for study. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Out of 200 patients of 5-74 years with chronic suppurative otitis media were examined and out of this Hundred and twelve (54%) of the patients were males with mean age of 33.44. &lt;em&gt;Pseudomonas aeruginosa&lt;/em&gt; was the commonest identified organisms the sensitivity pattern highly favoured Pipercillin, Amikacin and Polymyxin B, Cefoparazone. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; &lt;span lang="EN-IN"&gt;Chronic otitis media is more prevalent in males than females. Commonest organisms found were &lt;em&gt;Pseudomonas aeruginosa&lt;/em&gt; followed by &lt;em&gt;Staphylococcus aureus. &lt;/em&gt;Piperacillin, Amikacin, Gentamicin, Polymyxin B and Cefoperazone were found most effective agents against &lt;em&gt;Pseudomonas aeruginosa&lt;/em&gt;.&lt;/span&gt;&lt;/p&gt;

An investigation into discharge, visual perception, and appearance concerns of prosthetic eye wearers

ABSTRACTWe 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.