title: The psychosocial impact of living with an ocular prosthesis.
abstract: OBJECTIVE
  Many patients are satisfied with their ocular prosthesis, but some describe problems with social interactions, body image and self-esteem. Although both clinical practice and research suggest that the severity of a disfiguring condition does not predict distress, there has been little research with patients living with an ocular prosthesis. The objective was to explore the psychological impact of living with an artificial eye or cosmetic shell and determine the relationship between psychological well-being and clinical and psychosocial factors.
  
  
  METHODS
  A cross-sectional study between March and September 2008 at the ocular prosthesis clinic of Moorfields Eye Hospital, UK. The primary outcome measures were mood as measured by the Hospital Anxiety and Depression Scale (HADS) and appearance-related social anxiety and social avoidance, as measured by the Derriford Appearance Scale (DAS24).
  
  
  RESULTS
  Mean scores on the HADS and DAS24 were within normal range, but a considerable proportion of participants were experiencing significant levels of distress. Psychosocial adjustment was unrelated to most clinical and demographic variables, but was associated with a series of cognitive processes.
  
  
  CONCLUSIONS
  Psychological variables, rather than clinical or demographic factors, are associated with how a patient adjusts to wearing an ocular prosthesis. Such factors might be amenable to change through psychosocial intervention.
authors.affiliation: Health Services Research, City University , London , United Kingdom .
authors.forename: Hayley B
authors.initials: HB
authors.lastname: McBain
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Ezra
authors.forename: Geoffrey E
authors.initials: GE
authors.lastname: Rose
authors.forename: Stanton P
authors.initials: SP
authors.lastname: Newman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000523:psychology; D001828:Body Image / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000523:psychology; D005137:Eye, Artificial / Q000523:psychology*; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D020273:Orbital Implants / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012649:Self Concept; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D055815:Young Adult