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National Journal of Maxillofacial Surgery
 
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Table of Contents
ORIGINAL ARTICLE
Year : 2016  |  Volume : 7  |  Issue : 1  |  Page : 67-70  

Prevalence of ocular defects among patients visiting in an institutionalized hospital setting: A cross-sectional study


1 Department of Prosthodontics, Career Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India
2 Department of Prosthodontics, Faculty of Dental Sciences, KGMU, Lucknow, Uttar Pradesh, India
3 Department of Oral Pathology and Microbiology, Chandra Dental College and Hospital, Barabanki, Uttar Pradesh, India

Date of Web Publication19-Dec-2016

Correspondence Address:
Mayank Singh
Department of Prosthodontics, Faculty of Dental Sciences, KGMU, Lucknow - 226 003, Uttar Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0975-5950.196131

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   Abstract 

Purpose: The purpose of this study was to analyze the prevalence of ocular defect among different age groups, gender, side involved, and etiology.Materials and Methods: A retrospective study was conducted among referred ocular defect patients in a dental college in southern part of India over a 5 years period (2008–2012). Information regarding general identification, gender, age, affected side, and etiology was collected. The collected data were analyzed and grouped according to different age groups, gender, side involved, and etiology. Results: The ocular defects were more frequently observed in the young male population (66%).Trauma (46%) and pathogenic (44%) causes were the main reasons over nonspecific (8%) and congenital (2%) reasons. Conclusion: High prevalence of injuries and infections in young adults (mostly males) predominantly causing ocular bulb loss.

Keywords: Cross-sectional study, maxillofacial prosthesis, ocular defect, ocular prosthesis, rehabilitation


How to cite this article:
Raj N, Singh M, Raj V, Anwar M, Kumar L. Prevalence of ocular defects among patients visiting in an institutionalized hospital setting: A cross-sectional study. Natl J Maxillofac Surg 2016;7:67-70

How to cite this URL:
Raj N, Singh M, Raj V, Anwar M, Kumar L. Prevalence of ocular defects among patients visiting in an institutionalized hospital setting: A cross-sectional study. Natl J Maxillofac Surg [serial online] 2016 [cited 2017 Apr 24];7:67-70. Available from: http://www.njms.in/text.asp?2016/7/1/67/196131


   Introduction Top


The loss of an eye has been regarded as the greatest misfortune,[1] and Indian literature showed a 2–3-fold higher incidence of tumors of the eye as one of the main reasons in children below 15 years of age.[2]

Surgical procedures in the removal of an eye are classified into three general categories: Evisceration, enucleation, and exenteration.[3] The rehabilitation of a patient, who has suffered from an ocular loss, requires a prosthesis that will provide the optimum [4],[5] cosmetic and functional results. Very few literature have been published regarding the prevalence of ocular defects related to ocular prosthesis and most of them from developed countries which may not be relevant to educate, aware our interdisciplinary professional and patients in India.

In view of the great number of patients who suffer from eyeball loss and considering the need for treatment that reestablish esthetics and psychological health, a study is needed to know the prevalence of ocular defect among different age groups, gender, side involved, and etiology.


   Materials and Methods Top


The study was conducted at the Department of Prosthodontics in a dental college in southern part of India. A retrospective cohort data of ocular defect cases which were reported and treated in the department over a 5 years period (2008–2012) were carried out. Information regarding general identification, gender, and age at which patient lost the eye or diagnosis of atrophy was made, affected side and etiology, and time lag between eye loss and rehabilitation were gathered from the clinical records of patients. Based on the side affected, the loss/atrophies were classified as left, right, or bilateral. Etiology of the eye defect was considered under following categories: (i) Congenital (from birth), (ii) traumatic, (iii) pathologic (infection, tumor, or any other pathology), or (iv) not known.

The collected data were analyzed and grouped according to different age groups, gender, side involved, and etiology.


   Results Top


A total of 118 patients had reported to the department in the past 5 years. However, detailed data were available for only 100 patients. Two patients reported with an orbital defect were also treated in the department. However, due to insufficient number, they were not considered for the study. The evaluated data of 100 patients included in this study revealed that the ocular defects in relation to gender were more frequently observed in the male population (66%) [Figure 1].
Figure 1: The prevalence of ocular defect as function of gender

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Regarding the prevalence in relation to the side involved, it was observed that the right side was involved more (60%) when compared to the left side (40%) [Figure 2].
Figure 2: The prevalence of ocular defect as function of side involved

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Patients between 21 and 40 years age group were involved the most (32%), and the patients above 80 years of age were least involved (2%) among the age groups considered. However, the patient's between 0–20 and 41–60 years age group showed almost equivalent prevalence (26% and 27%, respectively) [Figure 3].
Figure 3: The prevalence of ocular defect as function of age

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Etiological prevalence revealed a predominance of trauma followed by the pathogenic cause (46% and 44%, respectively). However, nonspecific and congenital causes were less (8% and 2%, respectively) [Figure 4]. The time lag between eye loss and rehabilitation for majority of patients was found to be more than 10 years [Figure 5].
Figure 4: Etiology of ocular defect

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Figure 5: Time lag between loss of eye and rehabilitation

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   Discussion Top


The finding of the study revealed a predominance of males being affected with ocular defects, which agrees with the finding of previous investigations. Regarding the side involved, a predominance of the right side over the left side was observed. The age range revealed that 21–40 year age group was more frequently involved. The prevalence of ocular defects depending on etiology revealed the highest number of traumatic cases followed by pathologic causes. Among the loss of an eye due to pathogenic origin, infectious reasons were more.

Ocular prosthesis aims to restore facial esthetics, prevent eyelid collapse and deformity, protect the socket against injuries caused by foreign bodies, reestablish the correct route of lachrymal secretion to prevent accumulation in the cavity, and preserves muscular tone to avoid antisymmetrical alteration that might gradually occur.[6] Patient satisfaction with ocular prosthesis is relatively high.[7]

The finding of the present study revealed a predominance of males being affected with ocular defects, which agrees with the finding of previous investigations.[6],[8] These results may possibly be attributed to the fact that male population is usually more exposed to situations that can lead to eyeball injury and infections caused by a lack of hygiene and polluted environment. Males are still the majority of workers in areas of physical demand and are most commonly involved in road traffic accidents and cases of aggression or urban violence.

Regarding the side involved, a predominance of the right side over the left side was observed. These findings were not in accordance with previous studies which found the left side was more involved.[6] According to those authors, the findings were not statistically significant due to which they concluded that the side involved does not seem to be an important issue to be considered in preventive and educative campaigns.

The age range revealed that 21–40 years age group was more frequently involved, followed by 0–20 and 41–60 years age group. This predominance is probably attributed to the fact that individuals at age range of 21–60 have multiple activities and are therefore more exposed to situations that can lead to ocular defects. Age group of 0–20 is more reckless and explorative in nature leading to ocular defect. Similar results were observed in previous studies.[6]

The prevalence of ocular defects depending on etiology revealed the highest number of traumatic cases followed by pathologic causes. Coas et al.[6] who examined 3008 patients and verified 58.77% of injuries of traumatic origin and 41.22% of pathogenic origin.[6] Studies conducted by other authors were also in accordance with the present study.[9] Bearing in mind these results, it is imperative to adopt some preventive measures such as wearing protective eye glasses during activities that can lead to eyeball injury. Use of reinforced glass in vehicle windshields and building constructions, in addition to regular checkup by an ophthalmologist should be emphasized. To reduce the prevalence of ocular defects as a result of road traffic accidents or occupational hazards, wearing of the protective eyewear should be made compulsory.

Among the loss of an eye due to pathogenic origin, infectious reasons were more than neoplastic or any other pathogenic event. This observation signifies the level of hygiene and negligence of health on the part of the patients. This aspect has to be considered in community educative program. The time lag between eye loss and rehabilitation for majority of patients (60%) was found to be more than 10 years. This finding is probably attributed to the fact that people from rural background have low awareness about prosthetic rehabilitation.

In the present study, two patients were reported and treated with an orbital defect. However, due to insufficient number, they were not considered for the study. In this context, it needs to be stressed that due to the difficulty in fabrication and retention of the orbital prosthesis, and the surgeon should be much more conservative in the removal of the eye so that much of the adjacent tissues are preserved. This can ensure better prosthetic rehabilitation for the patients.


   Conclusion Top


Frequent injuries and infections in young adults (mostly males) were the main reason behind ocular bulb loss, and the time lag between eye loss and rehabilitation was found to be very high.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
Danz W Sr. Ancient and contemporary history of artificial eyes. Adv Ophthalmic Plast Reconstr Surg 1990;8:1-10.  Back to cited text no. 1
    
2.
Arora RS, Eden TO, Kapoor G. Epidemiology of childhood cancer in India. Indian J Cancer 2009;46:264-73.  Back to cited text no. 2
[PUBMED]  Medknow Journal  
3.
Perman KI, Baylis HI. Evisceration, enucleation, and exenteration. Otolaryngol Clin North Am 1988;21:171-82.  Back to cited text no. 3
    
4.
Reidy A, Minassian DC, Vafidis G, Joseph J, Farrow S, Wu J, Desai P, et al. Prevalence of serious eye disease and visual impairment in a north London population: Population based, cross sectional study. BMJ 1998;316:1643-46.  Back to cited text no. 4
    
5.
Khan AK. Ocular injury: Prevalence in different rural population of Bangladesh. Bangladesh Med Res Counc Bull 2013;39:130-88.  Back to cited text no. 5
    
6.
Côas VR, Neves AC, Rode Sde M. Evaluation of the etiology of ocular globe atrophy or loss. Braz Dent J 2005;16:243-6.  Back to cited text no. 6
    
7.
Song JS, Oh J, Baek SH. A survey of satisfaction in anophthalmic patients wearing ocular prosthesis. Graefes Arch Clin Exp Ophthalmol 2006;244:330-5.  Back to cited text no. 7
    
8.
Mattos BS, Montagna MC, Fernandes Cda S, Sabóia AC. The pediatric patient at a maxillofacial service: Eye prosthesis. Braz Oral Res 2006;20:247-51.  Back to cited text no. 8
    
9.
Saeed MU, Chang BY, Khandwala M, Shivane AG, Chakrabarty A. Twenty year review of histopathological findings in enucleated/eviscerated eyes. J Clin Pathol 2006;59:153-5.  Back to cited text no. 9
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]



 

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