Aug03
Posted by Dr. Kuldeep Raizada on Wednesday, 3rd August 2011
Care of the Eye ProsthesisDAILY ROUTINE:
The morning routine for hygiene care begins with a thorough hand scrub including the fingertips. A warm wet face cloth with a 'no more tears' baby shampoo is then applied to the eyelids since they are normally crusted with secretion. (This shampoo has a neutral pH and will not sting to the socket tissue or the fellow eye, plus it destroys bacteria.) The warm wet face cloth will soften the secretion allowing you to remove it by wiping inward toward the nose. (Do not wipe outward, because this could rotate the prosthesis out of position, or cause it to fall out of the cavity.)
Following removal, the prosthesis should be cleaned before insertion. Never clean the prosthesis with a cloth, abrasive soap, or toothpaste. The prosthesis is best cleaned with a mild soap or baby shampoo, with wet hands; gently wash the prosthesis between soappy fingers. All soap must be rinsed from the prosthesis and hands before reinsertion of the prosthesis. As the prosthesis is made of an acrylic plastic, it should never be soaked in alcohol, gasoline or bleach. Do not attempt to sterilize the prosthesis in an autoclave. In the office prosthesis can be disinfected in a cold sterilization media such as Cidex (manufactured by Surgikos Johnson & Johnson Co.)
SURFACE CLEANING OF THE PROSTHESIS AND EYE LIDS:
Excessive mucous secretions can occur when wearing an ocular prosthesis. Conditions such as head colds, winds dust, allergies and dirty hands can cause considerable secretion. Regular rinsing of the prosthesis with an ophthalmic irrigation solution can cause usually dislodged any surface deposits.
Proper Care of Artificial Eyes
Most eye physicians are of the opinion that artificial eyes can be worn continually and need only be removed for cleaning purposes. However, the eye physician should be consulted in each particular case.
For cleansing the artificial eye we recommend water and a mild soap, or any prescription that may be recommended by an individual doctor for the purpose of cleaning the eye. In the case of plastic eyes, the use of alcohol or other chemicals should not be employed in washing or cleaning the eye.
Infants and Children
Infants and children require special attention and should have their artificial eyes checked at regular intervals. Usually a larger eye should be fitted each year to induce stretching of the lids and development of the socket. If this is not done, further growth may be restricted and future results impaired.
Details in Fitting Artificial Eyes
There are so many details to be considered in fitting an artificial eye that too much attention should not be placed on one particular facet. Rather the artificial eye should be judged for its overall effect.
Many wearers insist on the artificial eye being as large as the natural eye. This is not wise since quite often a large eye produces a "stare", giving a very unpleasant effect. A discriminating eye wearer should guard against this possibility. It is better to have an eye a little smaller rather than larger so that the lids may properly cover the eye. Then, instead of attracting attention, the artificial eye will be unnoticed, and the maximum amount of movement will be secured.
It is preferable to be fitted with an artificial eye that produces a pleasing effect rather than one which is an "exact match." By varying the size of the iris or pupil the technician can often obtain a more desirable result. While an exact duplication of the iris color is important, size, shape, position, size of the iris, color of sclera (white portion of the eye) and the veining all combine to produce an effect that is truly life-like.
Correct pupil size for the individual patient is sometimes difficult to determine. The pupil dilates and contracts according to lighting conditions, and for most patients a medium size is the most desirable. However, some artificial eye wearers have very active pupils with considerable dilation or they have extremely light-colored irises, which drawn attention to the contrast between the pupil size of the artificial eye and the natural eye. For these patients we recommend a "night" eye, which is an extra eye with a larger pupil to be used for night wear.
CONSULTING THE OCULARIST:
There is no definite answer as to how long the prosthesis will last. Unlike the old style glass prosthesis, modern plastic prosthesis are durable and will not break. They can be polished when they become pitted or scratched. Plastic Prosthesis can be increased or reduced in size as required by changes in the design of the anophthalmic socket.
Changes in the socket occur from fat atrophy in the deep orbit and growth development in children. It is recommend the adult patient to be seen yearly and children every six months for a check of the condition and fit of the ocular prosthesis.
CONSULTING THE OPHTHALMOLOGIST:
The patient is encouraged to keep all follow-up appointment prescribed by the ophthalmologist. In addition, condition such as chronic discolored secretion, pain, or socket bleeding must be immediately brought to the attention to ophthalmologist.