Dry Anophthalmic Socket Syndrome-A Narrative Review

Area of Science:

• Ophthalmology
• Prosthetic Eye Care
• Ocular Surface Disease

Background:

• Dry Anophthalmic Socket Syndrome (DASS) is a common, underrecognized condition in prosthetic eye wearers.
• Symptoms include dryness, discomfort, discharge, and socket inflammation.
• Diagnosis involves symptom questionnaires and clinical signs like conjunctival staining.

Purpose of the Study:

• To review the anatomical, cellular, and molecular changes associated with DASS.
• To highlight the multifactorial etiology of DASS.
• To emphasize the need for comprehensive management strategies.

Main Methods:

• Literature review of anatomical, cellular, and molecular changes in DASS.
• Analysis of factors contributing to DASS, including meibomian gland dysfunction and inflammation.
• Examination of diagnostic criteria and management approaches.

Main Results:

• Common findings include meibomian gland dysfunction, reduced goblet cell density, and increased conjunctival inflammation (MMP-9, ICAM-1).
• Oxidative stress (NOX4, KEAP1, NRF2 dysregulation) plays a role.
• Eyelid malpositions, prosthesis factors, hygiene, and environment can exacerbate DASS.

Conclusions:

• DASS is multifactorial, requiring targeted management of inflammation, tear film, mechanical irritation, and eyelid position.
• Improved awareness, standardized diagnostics, and evidence-based protocols are crucial for prosthetic eye wearers.
• Addressing hygiene and environmental factors is also important for symptom management.