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Treating Contracted Eye Sockets
Author:
Joseph A. LeGrand Jr.,
BCO, BADO, FASO
LeGrand Associates
Philadelphia, Pennsylvania
Correspondence to:
Joseph A. LeGrand Jr., BCO,
BADO, FASO
485 Ridge Lane
Springfield, PA 19064
Phone: (215) 496-1307
Fax: (484) 420-6782
Email: joelegrand@gmail.com
Key Words
Contracted eye socket, entropion,
lagophthalmos, conformer
JOURNAL OF OPHTHALMIC PROSTHETICS
Caused by Long-Term Prosthesis
Neglect
ABSTRACT
Two case studies are presented involving patients who had neglected
their prostheses for many years, leading to chronic infection and eventual
contraction of the eye socket. Some lost socket volume was restored by
using conformer therapy and appropriate medication, thus allowing
retention of a prosthesis with acceptable cosmesis. After therapy, both
patients have on-going issues with incomplete lid closure of the affected
eye (lagophthalmos) and eyelid inversion (entropion). Ocularists and eye
physicians should emphasize to their anophthalmic patients the importance
of regular check-up visits to maintain the quality of their prosthesis and to
avoid long-term damage to their eye socket and eyelids.
Introduction
People who have prosthetic eyes
are advised to have a check-up visit
with their ocularist at least annually.
During this visit, the prosthetic eye
is cleaned and polished to remove
salt and protein deposits as well as
scratches. When a prosthesis is old it
may become pitted and rough and
a long-neglected prosthesis is likely
to have many surface scratches. A
prosthetic eye can also be damaged
by an improper care regime such as Figure 1. Prosthesis that had not been
polished for many years and appears
using alcohol to disinfect it, which
to be damaged by alcohol.
will cause crazing to the surface
of an acrylic prosthesis (Figure 1).
A prosthetic eye that has an irregular surface will cause irritation to the
.1
patient’s conjunctiva Constant irritation can lead to chronic infection,
or giant papillary conjunctivitis, and thus cause damage to the eye socket
and eyelids. A patient with a prosthetic eye who has not had a check-up for
many years might not only have a prothesis with poor surface quality, but
it also might not fit correctly. Typically, prosthetic eyes must be adjusted,
TREATING CONTRACTED EYE SOCKETS | 33