I had an email this week from a woman who has had a new prosthesis made interstate.
She was happy with the look of the eye but unhappy about the constant discharge she has been experiencing.
She told us that she felt the prosthesis was comfortable and her specialist said there was no infection. Why then was the discharge continuing?
I thought it might be worth setting out the types of questions I would want to explore in this sort of circumstance.
When did you have the eye removed?
Sometimes it can take a few months for everything to settle into place. Especially if you had a derma fat implant. They are a fantastic implant once settled but it does take a long time before the discharge stops.
Is it possible that the eye prosthesis is too small?.
When an eye prosthesis is made from an impression of the eye socket, all the spaces are filled nicely so that the tears evaporate the same as your other eye. If the prosthesis is too small, the tears pool into the spaces in the eye socket, turn milky then come out as a gloop when you blink.
Does the eye close properly?
If it is only in the mornings that there is muck then it could be that the eyelids are not closing properly over night. Get a friend to check if the eyelids close when your eyes are closed softly.
Do you find that you suffer a bit of dryness during the day as well?
This could indicate that the prosthesis is a little too large and by having it hollowed a touch it may help too alleviate both problems.
Is there any pressure points or tenderness in the eye socket? Or a spot which feels a bit itchy?
Sometimes when an eye prosthesis is not polished properly it can cause a discharge. The scratch or a sharp edge on the prosthesis can irritate the tissue which makes the eye socket produce extra tears to flush out the problem.
Who made your eye prosthesis?
A well made professionally fitted prosthesis will cause very few problems. It is worth hunting down a reputable and experienced ocularist.
5 Responses
I have had an artificial eye since about 1986 and had another surgery in 2000 to peg it. I live in Phoenix, AZ and I am having nothing but trouble and am in constant misery! I get the discharge but it has been working overtime here lately and by time I get home from work, I’m ready to take it out and put in my conformer. I rub and rub… clean the socket, wash the eye and put more siloptho but once it reaches that irritated state, there’s nothing I can do but take it out…
It has been a long time since I’ve had it checked to see if it needs to be refitted. What do you think? Remove peg and lose movement… refit eye, I am at my wits end!
Hi Rebecca,
Without seeing you personally and doing a proper investigation I am not able to tell you specifically what your problem is. I am happy to share some ideas which may help.
When the pegged implant came out it seemed like a great idea. The movement is very good and the pegging was popular. The problem with the peg is it creates an opening through the conjunctiva which allows bacteria to enter the orbital implant. The implant is an artificial environment and the body has no way to combat infection in the implant. There is a good explanation about enucleation at http://artificialeyes.net/adjusting-to-eye-loss-mind-map/eye-enucleation-operation/
There are only a few clients in my clinic who still have the peg. I have discussed this with other ocularists in Australia and they have all reported similar problems.
There are magnetic pegs available which give you good motility of the prosthesis without the problems of infection as they are implanted under the conjunctiva. This may be a better option for you. If you chose to remove the peg you may find the movement is not as good but you should still maintain a reasonable degree of movement. It is a quirk of monocular vision that you cannot see the degree of movement you have in the mirror. To see the movement of your eye, you should record it on video and play it back.
The problems you are experiencing may not have anything to do with the implant. You mentioned that you have not had the prosthesis reviewed by an ocularist for some time. Small scratches or protein build up on the prosthesis could cause problems. This could be rectified by having the prosthesis polished. Re shaping the prosthesis may also help.
If the problems you are experiencing are related to infection then it is important that you see a doctor to organise some antibiotics. Some people get relief from eye discharge using antihistamine drops for allergy or cortisone based steroid eye drops for severe irritation.
We recommend you only remove the prosthesis once a month. If you are taking it out every day then it is probably time to do something about it. Your first stop should be your ocularist. They will be able to refer you on for extra treatment if required.
I hope this helps. Please let me know how it goes.
Regards
Paul
Hi Rebecca
Its a while since you posted your message. I hope you have got some relief by now.
Ive had an artifical eye since I was a baby in 1968. From time to time I get excessive discharge but usually things are pretty good. I wash my eye and socket regularly (at least daily) and use salt water when I start to get more discharge than normal. I found that working in an air conditioned office dries the eye and I find washing the eye under the tap can relieve this.
I occassionaly get my eye polished and every so often return to get a new eye fitted and made. After a while the protein deposits just dont seem to go away.
Ive havnt heard of pegging before so I cant comment on it. Thankfuly as I was growing up I had new eyes made and my movement is ok.
Don’t accept the problems. Go back and get looked at. good luck.
Hi Tim,
Thank you for your response. Many years ago it was believed that an eye prosthesis should be treated much like a set of false teeth and taken out daily for cleaning.
These days however, after much research, it has been found that leaving an eye prosthesis in for about a month at a time makes for a far less aggrevated eye socket.
The theory behind this is, when you remove the prosthesis you wipe away the protective coating of tears. When replaced, the eye socket believes there is a foriegn body in it. It then bombards the socket with tears and antibodies to flush out the prosthesis. After a couple of days the prosthesis is nicely coated in tears and the eye socket accepts the prosthesis as a part of the body.
Every time you take it out, it upsets the balance. You should try and leave the prosthesis in until it tells you it needs to come out. You will find that after a month or three, it will feel a little uncomfortable or become a bit weepy. That will be your signal to remove and clean it.
Your eye socket doesn’t need cleaning on the inside. It will take care of itself as does your other eye, with tears. Using salt water in the eye socket can help if it is irritated but it is important to only use shop bought saline. If you do make it yourself then the proportion of salt to water should be one level teaspoon to 600ml’s. Any stronger then this will burn the eye socket and cause more problems.
For the dry eyes in an airconditioned office there is a fantastic product called Ocuglide. We sell it here for $15 plus a fiver for postage and handling. It is silicon oil based and one drop that will lubricate the artificial eye for the entire day. We have had great feedback especially from intrepid travellers that spend a lot of time on planes.
I hope this info will encourage you to minimise the amount of time you handle the prosthesis.
Were can I find the Ocuglide in colorado