Posts Tagged ‘health’

Tears in the Artificial Eye Socket

Wednesday, October 16th, 2013

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 for Artificial Eyes

Wednesday, May 29th, 2013

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.

Many of our patients have found great success combining 1-2 drops of an artificial tear with one drop of Sil-Ophtho or Ocu-Glide, to provide an instant tear film and instant relief.

Similasan Dry Eye Relief #1Similasan Allergy Eye Relief #2Similasan Computer Eye Relief #3

Artificial Eye Silicone Lubricants

Wednesday, May 18th, 2011

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.

Artificial Eye Lubricants

Conditions that deplete tear film and indicate the use of a lubricant:

  • Air Conditioning,
  • Wind,
  • Dry heat,
  • Frigid cold,
  • Smoke,
  • Dust, and
  • Long duration of computer/television use.

Sil-Ophtho Heavy Silicone LubricantOcu-Glide Silicone LubricantSil-Ophtho Silicone LubricantArtificial Eye Lubricant

American Society of Ocularists Meeting in Seattle

Wednesday, April 6th, 2011

This weekend, the American Society of Ocularists is holding their semi-annual educational meeting in Seattle, Washington. This will be the first time the ASO has met in Seattle and it proves to be an exciting line-up of speakers and programs. Two of our distinguished eye physicians will be speaking at the conference.

Bryan Sires, MDBryan Sires, MD, PhD, FACS from Allure will be speaking on the anatomy and physiology of eyelids.

Abstract: The specialized anatomy of the eyelid provides the physiological benefits to the eye. The eyelid is paramount in protecting the eye and enhancing vision. This comes about by the function of eyelid opening and closure along with the production of tears for the visual medium. A thorough understanding of normal eyelid anatomy and physiology allows one to appropriately examine this structure. Deviations from normal allow one to understand diagnostic entities and to provide the basis for treatment.

Avery Weiss, MDAvery Weiss, MD, from Seattle Children’s will be speaking about ocular diseases in infants and children.

Abstract: This lecture will focus on congenital abnormalities of the globe in which the services of an ocularist are frequently needed. The first portion of this talk will focus on postnatal growth of the eye and orbit, ocular malformations with emphasis on microphthalmia, anophthalmia and glaucoma. The second portion will focus on acquired diseases of the globe especially intraocular tumors, retinal vascular diseases, retinopathy of prematurity and trauma for which enucleation is a treatment option. The main goal of this lecture is for the ocularist to learn more about the ocular diseases in infants and children that may benefit from orbital expanders and ocular prosthetics.

Clean Air in the Ocularist Office

Thursday, January 6th, 2011

Often patients will enter the ocularist office expecting to catch a strong whiff of the chemicals used to process the acrylics. We are happy to declare that when one enters our office, these smells are not present! We have gone to great measures to ensure the chemicals we use are handled in safe and appropriate ways, and that the fumes are collected at the source, resulting in almost no exposure to the patient or ocularist alike.

We have had filtration systems in place for over 15 years, but it was time to upgrade our systems last summer. Our goal was to provide a safe office environment and near total fume capture. How did we accomplish this? We have been very impressed by the air scrubbers produced by Electrocorp, which is now run out of Canada. These machines are vibrationless and almost silent. The only sound is the airflow, the motor noise itself is almost undetectable.

We have 3 stations to capture fumes at the source and we also have 2 room scrubbers that run full time, pulling any residue particles out of the air. These machines are HEPA rated air filters. HEPA stands for high efficiency particulate air filter and describes a filter that can remove at least 99.97% of airborne particles 0.3 microns in diameter. After the HEPA filter is a large cylinder of activated carbon, which permanently remove chemicals and dust from the air.

Here are 2 short videos of our systems pulling CO2 from dry ice into the filters: Paint Room Filtration System Video –  Lab Filtration System Video

Our 3 stations have been specifically designed for the purpose of capturing monomer fumes, before they disperse into the lab. We used stainless steel grates and acrylic fume hoods to direct the airflow with very good results. Here are a few photos of our finished stations. We are very excited to be able to create a clean, healthy environment for us as ocularists, but also for you as patients!