Abstract
Purpose: :
Improved visual function after ptosis surgery has not been shown to directly relate to improved quality of life for patients. The role of appearance concerns and psychological factors relating to ptosis have been suggested as key factors mediating the relationship between successful corrective surgery and psychological wellbeing. No previous research has sought to identify these psychological factors.
Methods: :
In this mixed methods study, data was collected from twenty pre-and post-operative ptosis patients using validated questionnaires. In addition, post-operative interviews have so far been conducted on ten patients. Questionnaires included Derriford Appearance Scale (DAS) and the Hospital Anxiety and Depression Scale (HADS). Interview questions focussed on functional impairments and potential psychological and social implications of the condition. Patients reflected on the impact ptosis had on their quality of life pre and post surgery. Interview data was transcribed verbatim and analysed using Inductive Thematic Analysis.
Results: :
Thematic Analysis of the post-operative interview group reveal four inter-related themes: functional impact, psychological impact, social impact and impact on behaviour. Male and female patients differed in terms of how they interpreted and coped with the implications of ptosis, though both male and female patients were similarly affected by the social impact. All post-operative patients found these negative impacts had been greatly improved or entirely relieved by surgery. 100% of patients reported functional improvement, many spoke about improvement in social interaction, with 60% having improved self-confidence and 80% had reduced anxiety from no longer having to adapt their behaviour in order to deal with their ptosis.
Conclusions: :
Ptosis can impact of patient quality of life in ways similar to other conditions which affect the appearance of the eyes, such as strabismus. This study suggests that gender, appearance concerns and psychological factors, such as the impact ptosis has on social interactions, mediate the relationship between successful corrective surgery and psychological wellbeing.