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UK National Artificial Eye Questionnaire study: comparisons between cosmetic shell and artificial eye users. Part 1: demographics, comfort and satisfaction
  1. Yinon Shapira1,
  2. Emma Worrell2,
  3. Katja Ullrich1,
  4. Andre Litwin1,
  5. Raman Malhotra1
  1. 1 Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
  2. 2 Maxillofacial Prosthetics, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK
  1. Correspondence to Yinon Shapira, Corneoplastic Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead RH19 3DZ, UK; yinonshapira{at}


Aims To compare the unique experiences related to artificial eye (AE) versus cosmetic shell (CS) wear.

Methods In this observational, cross-sectional study, the National Artificial Eye Questionnaire (NAEQ) was employed nationwide within the National Health Service England. The proportions or mean values of the aetiology of sight or eye loss, demographics, length of prosthesis wear, reported adjustment time to the prosthesis, comfort, discharge and satisfaction of appearance were compared between AE and CS respondents.

Results Overall, 951 respondents wore an AE, while 238 wore a CS. In both, trauma was the leading cause for the prosthesis (47.6% and 44.1%, respectively); however, these groups differed in the proportions of the other aetiologies (p<0.0001). AE respondents were generally older (p=0.002) and had longer overall prosthesis wear (p<0.0001) compared with CS respondents. The overall comfort score was similarly, relatively high in both AE and CS respondents (80.4±0.73 vs 81.41±1.45; p=0.51). The discharge-related patient satisfaction ranking was relatively low, in both groups, with a small trend towards worse discharge scores among AE wearers (59.41±0.76 vs 62.26±1.52, p=0.094). Self-reported length of time that has taken to adjust to wearing the prosthesis was not significantly different (p=0.17). Appearance of the eye (p=0.032) and motility of the prosthesis (p<0.0001) were ranked superior by CS respondents compared with AE.

Conclusions This study characterises unique aspects of CS versus AE in a large national cohort. The results should provide reinforcement to the gain in popularity of CS.

  • Cosmesis
  • Prosthesis
  • Rehabilitation

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  • YS and EW contributed equally to this work.

  • Contributors YS: analysis and interpretation of data, drafting of manuscript and critical revision. EW: conception or design of the work, acquisition of data, drafting of manuscript and critical revision. KU: analysis and interpretation of data and critical revision. AL, RM : conception or design of the work, analysis and interpretation of data and critical revision.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Ethics approval National Research Ethics Service (NRES 17/ES/0010). A Health Research Authority (HRA) approval was granted for each participating recruiting site.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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