Hygiene Care for the Ocular Prosthesis, Eyelids and Eye Socket

DAILY ROUTINE

The morning routine for hygiene care begins with a thorough hand scrub, emphasis on 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 or smart 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.)

Once the lids and eyelashes are free of secretion, you can proceed to one of the following routines for cleaning the ocular prosthesis, while it is in the cavity:


For the person who showers:
The water can be adjusted to a fine spray. The sighted eye is then covered with the hand for protection while the spray strikes the lids and prosthesis.

For the non-shower buff:
A one ounce ear syringe can be used with tap water or distilled water. The water is sucked into the syringe.
The syringe is then held in the palm of the hand, while the hand is in a 'hand salute' position. The syringe is also supported by the bridge of the nose while the tip is near the inner edge of the prosthesis.
The head is tipped to the side and the drainage is caught in a face cloth or hand towel.


If you have sinus, hay fever, asthma, allergies or a cold in you system, expect an increased amount of tearing and secretion. This is a natural experience.
It is suggested you use a normal saline solution which you can purchase at your pharmacy or you may make it yourself (1Ú4 teaspoon of table salt to 1 quart of boiled water).
Keep this in a covered container at room temperature, not in a refrigerator.
The solution is good for a week.
Irrigate three times a day until the secretions abate.

Always carry a pocket pack of tissue and use it when necessary to remove any secretion from the prosthesis or lids.
The average amount of wiping is three to five times a day.
Avoid the use of a handkerchief or bare fingers.


WARNING
Never place the prosthesis in alcohol or other harsh chemical substance, this can damage the plastic surface and cause irritation to the conjunctival tissue.



MONTHLY ROUTINE

It is suggested the prosthesis be removed once a month, and checked for protein deposits.Ê Protein deposits will give the prosthesis a dull appearance.Ê The prosthesis can be washed with a soft face cloth with soap, liquid detergent or 'no more tears' type baby shampoo.Ê Rinse the prosthesis with water and reinsert.

Insertion of Ocular Prosthesis into the Eye Socket

(Instructions for Caregiver to the Patient)

It is easier to insert the ocular prosthesis with the fingers (for more control), than it is using the suction cup.Ê Chances are the patient may blink or squeeze the lids during this insertion process, resulting in loss of suction and the possibility of dropping the prosthesis.

Cleansing of the Hands prior to Insertion

Please be advised that bacteria that frequently causes conjunctivitis and socket infections exists on the skin.Ê We would therefore, recommend using a 'no more tears' baby shampoo for a thorough hand scrub with emphasis on the fingertips.Ê This shampoo destroys bacteria and it has a neutral pH.Ê The shampoo should also be applied with a warm wet facecloth to the ocular prosthesis.Ê You may rub it vigorously with the facecloth to remove any dried protein deposits on its surface.Ê Rinse well prior to insertion.

Insertion of the Ocular Prosthesis with Fingers

Step 1. Moisten prosthesis with water or any contact lens wetting solution for easier insertion.

Step 2. Hold the prosthesis by the outer edges with the thumb and forefinger.Ê (The index finger will come into use in Step 4 & 5.)Ê The black dot (left eye) or two dots (right eye) indicate the top of the prosthesis.

Step 3. Have the patient look downward and, at the same time, place your thumb or finger of your free hand on the upper eyelid and lashes.Ê Pull the upper eyelid toward the eyebrow.Ê This will create a large gap.

Step 4. Bring the prosthesis up past the lower lid and set it flush once it is partially past the lower eyelid and touching the orbital tissues.Ê You may now place the index finger on the front of the prosthesis, allowing you to release the thumb and forefinger hold.

Step 5. The index finger will continue to push the prosthesis up and under the upper lid until it is completely in the socket.

Step 6. In one swift motion, release hold of the upper lid, and pull the lower lid downward, to allow the entire prosthesis to slip into the cavity.