Presentation revealing several main concepts regarding management of anophthalmic socket. It includes orbital implants during amputation surgery (evisceration or enucleation), managing the socket immediately after the removal of the eye; fitting the artificial eye and taking care of it during rest of the time. What the ophthalmic nurse and general ophthalmologist should know about artificial eye?

1. On artificial eyes
29th May 2016
Dr. Anton Vurdaft
FCOphth(ECSA), FICO

2. Few simple concepts
regarding artificial eyes
in anophthalmic patients

3. Any eye removal necessitates orbital
implantation
•Why?
Primary orbital implants in retinoblastoma: DOI: 10.1111/aos.12915, 10.1371/journal.pone.0121292

4. Any eye removal necessitates orbital
implantation
Anophthalmic
Socket
Syndrome:
Loss of volume,
Deepening of upper
Lid sulcus,
Shrinkage of fornices

5. Any eye removal necessitates orbital
implantation
(!) Inability to
insert an artificial
eye in the long
term

6. Any eye removal necessitates orbital
implantation
(!) Inability to insert an artificial
eye in the long term
On the picture:
Severe socket constriction
(upper and lower fornices – flat)

7. Any eye removal necessitates orbital
implantation
(!) Inability to insert an artificial
eye in the long term
On the picture:
Severe socket constriction
(upper and lower fornices – flat)

8. Upon completing the surgery – put
tetracycline ointment and a big
conformer to stretch the conjunctival
fornices. Apply crape bandage for 24
to 72 hours or perform temporal
tarsorrhaphy.
•Why?

9. Perform Tarsorrhaphy at the End
Severe chemosis in the postop days after evisceration with orbital implant

10. Counsel the patient accordingly
preoperatively and postoperatively
(What? Why? What’s next?)
•Why?

11. Counsel properly!
She was not offered an artificial eye before the removal. She has got lower lid
ectropion and shallow fornices instead!

12. Fitting of the artificial eye:
after 6-8 weeks

13. Artificial eye will move naturally only
in conversational distance (not able
to deviate to the extreme gaze
positions)

14. Patient should be taught how to
insert and remove the eye (devote
separate time, quiet room and a
mirror)

15. © Murray McGavinhttp://www.cehjournal.org/article/management-of-an-eye-prosthesis-or-conformer/

16. Notch is superonasally!

17. Patient should be encouraged to
minimize handling the artificial eye.
No daily removal and cleaning is
necessary.

18. Lubrication may improve comfort (no
tap water! Ringers, Saline or Artificial
Tears may work well instead, packed
in the eyedrops bottles)

19. There is only one eye now. Encourage
using the protective plastic glasses.

20. Evaluating the socket of
anophthalmic patient:
1) Socket is fit or infmalmed?
2) Lower lid is healthy or lax?
3) Can the patient blink naturally?
4) Any lagophthalmos?
5) Are the fornices deep enough?
6) Giant papillae of upper tarsal conj?

21. Evaluating the prosthesis
1) Artificial eye is well centered?
2) Horizontal symmetry?
3) Equal prominence?
4) High gloss, wet shine?
5) Scratches, debris of the surface?
6) Moving naturally within 10-15 degrees?

22. One artificial eye should
serve for 6-8 years.
Easily gets damaged while
dropped down.
Advise annual check up.

24. Thank you
“On Artificial Eyes”
Dr. Anton Vurdaft
FCOphth(ECSA), FICO