Abstract
Purpose: Previous research suggests clinical assessments of severity correlate poorly with Health Related Quality of Life (HRQoL) or emotional well-being in ophthalmic conditions affecting the appearance of the eyes and that six key intervening cognitive variables (dispositional optimism, social acceptance, fear of negative evaluation, appearance discrepancy, appearance salience and appearance valence) may be more important within the adjustment process. A systematic review was conducted to identify and consider this evidence from relevant studies.Methods: The selected electronic databases, Medline, Psychlnfo, and Cinahl were used to search for studies published between January 2000 and September 2018. Methodological quality was assessed using a 7-item scale developed from the Newcastle-Ottawa Scale.
Results: From a pool of 2,831 articles, nineteen met criteria for inclusion criteria, reporting on four specific conditions, thyroid eye disease / graves’ ophthalmopathy, strabismus, ptosis, ocular prostheses wearers and one general sample of ophthalmic patients with conditions affecting appearance. A meta-analysis found a moderate correlation between assessment of severity, as measured by the Clinical Activity Score (CAS) and the Classification of TED severity tool (NOSPECS) and both the visual functional and appearance HRQoL subscales of Thyroid Eye Disease Quality of Life Questionnaire (TED-QoL) and Quality of Life Questionnaire in Graves’ Ophthalmopathy (GO- QoL). Meta-analyses also found moderate/strong associations between valence, social acceptance and appearance related anxiety (DAS-24), appearance discrepancy, valence and depression (HADS-D) and valence, salience, appearance discrepancy and anxiety (HADS-A). Discussion: To draw firmer conclusions regarding the associations between clinical severity, the pre-identified intervening cognitive variables and HRQoL, depression and anxiety in individuals with ophthalmic conditions affecting the appearance of their eyes, further research addressing methodological limitations is necessary. These preliminary findings highlight the therapeutic opportunities that may arise from cognitive behavioural therapy (CBT) and acceptance and commitment therapy (ACT) for this population of patients.
| Date of Award | Dec 2019 |
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| Original language | English |
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