Posts Tagged ‘artificial eyes’
Here is a great article written by Marcello Di Cintio of Swerve. Features the work of Shirley Weyland of Calgary and story of Leif Erickson of Vancouver. Check it out!
Coating the inner and outer surfaces of the artificial eye is a tear film. People normally blink the eyelids about every six seconds to replenish this tear film. Tears have four main functions on the artificial eye:
- wetting the conjunctival lining of the socket, preventing damage due to dryness,
- creating a smooth optical surface on the front of the microscopically irregular acrylic surface,
- providing lubrication and acting as a vehicle to remove debris from the prosthetic surface, and
- containing an enzyme called “lysozyme” which destroys bacteria.
The tear film resting on the prosthetic surface has three layers:
- Lipid layer,
- Aqueous Layer, and
- Mucin Layer.
The top layer of the tear film is the lipid or oily layer. This layer prevents the aqueous layer beneath it from evaporating, as well as preventing the tears from flowing over the edge of the lower eyelid.
Below the lipid layer is located the aqueous layer of the tear film. This middle layer is the thickest of the three tear layers. The aqueous fluid contains salts, proteins and lysozyme.
The bottom layer is the mucin layer. This layer adheres to the “hydrophobic” (water-repelling) acrylic surface of the prosthesis. Therefore, for a tear layer to be able to remain on the prosthetic surface without rolling off, the “hydrophilic” (water-attracting) mucin layer is necessary.
A deficiency of any of the three layers of the tear film can lead to a “dry eye” condition, causing anything from mild eye irritation to severe pain. Interestingly, in some cases, excessive tearing or watering of the eyes can be a symptom of a dry eye condition. This is because when, for whatever reason, there is an inadequate normal tear layer on the eye, irritation results; the latter causes an overproduction of the lacrimal gland and a flooding of lacrimal fluid into the eye.
Besides excessive tearing, symptoms associated with dry eyes can include the following:
- eye irritation, scratchiness, grittiness, or pain,
- redness of the conjunctival tissue,
- a burning sensation in the eye,
- a feeling of something in the eye,
- eyes that feel “glued shut” after sleeping,
- excess mucosal drainage, and
- discomfort wearing the prosthesis.
There can be multiple causes of a dry eye condition for a prosthetic eye wearer:
- lid or blinking problems,
- reading or working at a computer screen for long periods of time,
- medications like antihistamines, oral contraceptives, beta blockers, diuretics, tranquilizers, pain relievers, or antidepressants,
- a dry climate (including heating and air conditioning in a home, airplane, or hotel room), wind, UV radiation, tobacco smoke, and dust,
- diseases such as rheumatoid arthritis, Sjogren’s syndrome, keratoconjunctivitis sicca, xerophthalmia, lupus erythematosus, Grave’s disease, diabetes, or scleroderma
- hormonal changes accompanying menopause,
- chemical, radiation, or thermal burns to the eye,
- vitamin A deficiency,
- aging, since the tear glands produce fewer tears as we age,
- protein adhesion to prosthetic surface,
- scratches on the prosthetic surface, or
- ill-fitting prosthesis.
A dry eye problem often can be relieved with the use of lubricating eyedrops, which are instilled daily or as needed onto the prostheic surface. These types of drops can soothe the socket, moisturize dry spots, supplement tears, and protect conjunctival tissue from further irritation. They provide comfort and a nice shiny, even tear layer over the prosthesis. They have a higher viscosity than natural tears, so they need to be insilled less frequently, often just once or twice per day. The lubrication allows for easier blinking, less drainage from the socket, and a very natural appearance.
Soothing eye drops are also available. These drops have the same viscosity as natural tears, which means they will not be as long lasting as the lubricants, but they do have soothing properties to control allergies, discomfort, itchiness, inflammation and excess mucosal drainage.
Some patients chose to try “artificial tears” type eyedrops to alleviate the sypmtoms of dry eye. These are not very successful because they do not last very long. Most “artificial tear” drops only contain saline, which evaporates very quickly. Some eyedrops contain “vasoconstrictors” (chemicals such as tetrahydrozaline or naphazoline), which constrict the conjunctival blood vessels, thereby reducing the amount of redness on the surface of the eyes. We do not recommend these drops for prosthetic eye wearers as they damage the tissue lining the anophthalmic socket.
Should you have any difficulty with your current regimine, we recommend working with your Ophthalmologist, Optometrist and your Ocularist to determine the root of your symptoms and come up with an appropriate solution. With a healthy fit of your prosthesis, frequent polishing and proper lubrication, your prosthesis should be able to fit and function well. Our goal is to provide our patients with excellent comfort and cosmesis for the most natural, realistic result possible.
Soothing eye drops can be indispensable for the comfortable wearing of an ocular prosthesis. These drops are not specific to prosthetics, but they work very well to alleviate dry, tired, allergy symptoms.
An anophthalmic socket is similar to a sinus. Often patients report that their sockets react first when they contract a cold or sinus infection. When irritation occurs or when their allergies flare up, soothing eye drops will be very helpful in calming the fragile conjunctival tissue. Ease your discomfort by matching your most common symptoms with the drops below.
Similasan drops have been used by our patients with very good success. These soothing drops provide lubrication and their specific soothing properties. Choose from Dry Eye Relief, Allergy Eye Relief and Computer Eye Relief.
Check out this story on KTVQ in Billings, Montana about Brynn Pule – certainly one of the cutest little ladies we know! What a delight that this family can share their struggles to encourage others. Thanks Brynn!
If you have a story that you would like to share, contact us and we would be happy to post it here.
John Sharify with King 5 News followed a patient of ours through the whole process of having their eye removed due to pain and being fit with their new ocular prosthesis. This story aired on November 18th, if you missed it, check it out here: Artful Eye Surgery.
This is a truly transparent look into the life and thoughts of Captain Scotty Smiley, who was injured in Iraq and lost sight in both eyes. His faith, his determination, or the love for his wife, I am not sure which shines brighter. This story is an inspiration for us all!
Hope Unseen is available online here.
Here are some praises:
“Scotty Smiley’s story is one all Americans should hear. It will inspire them in tough times and help them through some of the difficult challenges they face in life.”
— Senator Bob Dole
“I have known Scotty Smiley for nearly ten years–since the beginning of his friendship with my son Edward at West Point. He was a role model for our family before his injury, and his impact on us has only grown since that day in Mosul. Scotty has an incredible story to tell and God is using him in a remarkable way. All of the Grahams look forward to reading and sharing Scotty’s story with millions.”
— Franklin Graham
“Scotty Smiley is an American Hero! Scotty and Tiffany have been an inspiration to the Duke Community, to Team USA Basketball, and to me personally. He shared his story with our Olympic Gold Medal– winning basketball team, and now he shares it with all of us to show how character ultimately wins.”
— Coach Mike Krzyzewski
The lubricants listed below all work to increase the tear film that coats the surface of your prosthetic eye or scleral shell providing more comfort, easier blinking, and a more natural appearance. These lubricants are developed specifically for artificial eyes.
The higher the viscosity, the thicker and longer lasting the lubricant. While this would indicate the highest viscosity lubricant as the best choice, there are a few more factors to consider. The purpose of a lubricant with an ocular prosthesis is to decrease the friction between the eyelids and the prosthetic surface. The best way to decrease friction is to have a smooth prosthetic surface and a good tear film.
The higher viscosity silicone lubricants will boost the outer tear film layer, reducing the evaporation of tears. The soothing drops and lower viscosity lubricants will help boost the aqueous layer of the tear film. In cases where tear production is limited, it may be helpful to use both a lubricant and a soothing drop to replenish the tear film.
Conditions that deplete tear film and indicate the use of a lubricant:
- Air Conditioning,
- Dry heat,
- Frigid cold,
- Dust, and
- Long duration of computer/television use.
This week, we heard an excellent lecture at our semi-annual meeting of the American Society of Ocularists about psychological coping techniques for our patients with ocular prosthetics and vision loss. Allison Fine, MSW is a medical social worker and counselor who works with individuals, couples and groups in the Seattle area. She provides compassionate support through her private practice for those dealing with chronic illness, grief and loss, depression, anxiety, and end of life issues. Below is a synopsis of how patients can be affected by depression and how they can cope with it as well!
Signs and Symptoms of Depression
- Increase or Decrease in Weight (Lack of Appetite or Eating More Frequently)
- Increase or Decrease in Sleep Habits (Fatigue/Insomnia)
- Loss of Interest in Daily Activities
- Irritability, Anger, Frustration, Restlessness
- Trouble Concentrating or Difficulty Making Decisions
- Unexplained Aches and Pains
- Feelings of Hopelessness or Helplessness
- Suicidal Thoughts or Actions
- *If you are experiencing any or all of these, you may be experiencing depression.
Common thoughts and feeling related to ocular prosthesis/eye loss/vision loss and depression:
- I feel sad that I have lost my eye/vision.
- Why did this have to happen to me?
- Will I ever get used to my new prosthesis?
- I feel damaged.
- Will people still see me the same way with my prosthesis?
- How do I explain to others what I have been through?
- Do I have to explain to others what I have been through?
- Eat Well
- Sleep Well
- See medical professionals regularly for check-ups and medical concerns
- Take medications/supplements regularly
- Spend time with partners, family and friends
- Participate in hobbies/activities you enjoy or try something new
- Practice positive thinking
- Make time each day for relaxation and fun
- Meditate/practice breathing exercises
- Seek the support of a counselor
- Join a support group