April 2011
Volume 52, Issue 14
ARVO Annual Meeting Abstract  |   April 2011
The Psychological Impact of Ptosis
Author Affiliations & Notes
  • Richard A. Harrad
    Bristol Eye Hospital, Bristol, United Kingdom
  • Hollie Richards
    University of the West of England, Bristol, United Kingdom
  • Liz Jenkinson
    University of the West of England, Bristol, United Kingdom
  • Helen Herbert
    Bristol Eye Hospital, Bristol, United Kingdom
  • Helen Garrott
    Bristol Eye Hospital, Bristol, United Kingdom
  • Nicky Rumsey
    University of the West of England, Bristol, United Kingdom
  • Footnotes
    Commercial Relationships  Richard A. Harrad, None; Hollie Richards, None; Liz Jenkinson, None; Helen Herbert, None; Helen Garrott, None; Nicky Rumsey, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 1567. doi:
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      Richard A. Harrad, Hollie Richards, Liz Jenkinson, Helen Herbert, Helen Garrott, Nicky Rumsey; The Psychological Impact of Ptosis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):1567.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : Federici et al (1999) found that ptosis surgery significantly improved quality of life measures in patients; this improvement was not directly related to improved visual function. It has been suggested that it may be due to underlying psychological factors relating to ptosis (Fante & Bartley, 1999). There has been no previous research into the effect of ptosis on concerns about appearance and very little research into the subjective experience and psychological effects of ptosis.

Methods: : Twenty-one adult patients recruited from Bristol Eye Hospital were interviewed, and completed measures prior to surgery. Measures used were Derriford Appearance Scale (DAS), Fear of Negative Evaluation (FNE), CARVAL (measure of the subjective importance of appearance) and the Hospital Anxiety and Depression Scale (HADS). Interview questions addressed the psychosocial impact of ptosis.

Results: : Analysis of pre-operative data shows a significant difference between men and women in terms of psychosocial adjustment to the effects of ptosis on appearance, with women scoring above the threshold for poor levels of adjustment [female DAS=42.5, male DAS=25.1, p < .05. Threshold=40]. HADS scores were below the clinical threshold of 11 [Depression: mean = 5.6, Anxiety: mean= 8.2], indicating that psychosocial maladjustment was due to ptosis, and not due to associated underlying depression or anxiety. Preliminary analysis on the interview data revealed four main themes, all of which interacted to some extent: impact on appearance; psychological impact; functional impact and impact on behaviour.

Conclusions: : These results, using validated instruments, show that there is a psychosocial impact to ptosis which appears to involve the effects of ptosis on appearance, in addition to the interaction between function and behaviour. These results can now be compared to data from other conditions that produce a visible difference, and assist decision-making in healthcare resource allocation.

Keywords: eyelid • quality of life • clinical (human) or epidemiologic studies: natural history 

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