The way someone cares for their ocular prosthesis is much like the prosthesis itself - unique to the individual. What works for one person may not work for another. It all depends on what’s needed. But whether you can forget about the eye until your polishing appointment , or you remove and wash it daily, every artificial eye will need attention at some point.
This list of cleaning and handling tips and tricks contains some obvious, and some not so obvious, bits of advice to help you keep your prosthesis in top condition for as long as possible.
1: Less is more
The first, and simplest, tip is to leave your eye alone as much as possible. The socket has its own cleaning processes and, for the most part, they will be sufficient for cleaning your prosthesis. Human hands are rarely sterile or even really clean, so touching your eye can inadvertently introduce germs and dirt into the socket where it will make things uncomfortable. Even when you have washed your hands, the simple act of removing the ocular can be enough to cause discomfort until your socket returns to its natural equilibrium.
And cleaning the ocular too often can cause problems. This is supported by a 2012 study published by the University of Auckland, New Zealand. This study looked at the build up of surface deposits on prosthetic eyes over time, the effects of polishing on these deposits, and the resultant “wettability” (i.e. how well liquids will stick to a surface). The data suggests that an eye with some surface deposits may be more comfortable to wear than an eye with none, because “the presence of deposits…improves the lubricating properties of socket fluids which, in turn, may result in less frictional irritation of the conjunctiva when the prosthesis moves.”
Read the study for yourself here.
This won’t last forever, though, since the continuous accumulation of surface deposits will eventually cause discomfort that only a professional polish by your ocularist will resolve.So, unless you have a specific need to remove your eye, it’s better to just leave it alone.
2: Soft place to land
Although artificial eyes are regularly referred to as “glass eyes,” now, they are pretty much always made of acrylic plastic. An acrylic eye is much tougher than a traditional glass eye, however they are not impervious to damage. Scratches on the surface that cause discomfort are the most common problem, but it’s also possible to chip an eye if circumstances are just right (or more correctly, just wrong). This can happen when an ocular is dropped on a hard surface - often when you remove your eye to clean it.
Kitchens and bathrooms often have tiled floors and porcelain sinks which are an ocular’s worst enemy. One slip while removing or replacing an eye can land you in chip city. But a good way to avoid this is to set a clean towel on a convenient surface and lean over it while you are working. This could be the bathroom counter or sink in front of your mirror, or a table in the kitchen--wherever you are comfortable. The towel also provides a soft surface to set your ocular on.
3: Clean enough to eat off
When you do remove your eye for cleaning, it’s best to use the gentlest cleaners that you can. Surface deposits and scratches might be annoying, but if you use harsh cleaners in an attempt to make your eye more comfortable, you might end up causing more damage and ultimately more discomfort. A good product to use for this purpose is common dish soap. Soap without excessive fragrance is preferable, but provided you rinse the prosthetic well before returning it to your socket, it’s unlikely to cause irritation. Scratches on the surface won’t be remedied with dish soap, but please don’t try to polish your own artificial eye! Ocularists use specialized polishes and tools to achieve an optical quality finish, and anything else risks doing worse damage or even rendering the eye unwearable. Anything that can’t be removed with dish soap, or any of the other suggestions in this list, should be left to the professionals.
4: Getting “aggressive”
If you are faced with stubborn surface deposits that dish soap just doesn’t touch, the last option before you contact your ocularist is simply a wet paper towel. This might sound strange, but it’s actually quite effective and won’t risk any damage to the surface. And it definitely has to be a WET paper towel, because a dry one will have little effect and might even make the discomfort worse.
5: No drain, all gain
If you are washing your artificial eye then you are probably doing it in the sink, and where there are sinks, there are drains. Most drains have guards, and most eyes are too big to slip through them, but occasionally the unthinkable happens. (Ask me how I know!) If your eye is on the smaller side, particularly thin like a scleral shell, or your drain doesn’t have a guard, then you should definitely put the plug in or use a temporary guard of some kind before the next time you do a cleaning. There are many reasons why people might need a new eye, but few are more frustrating or avoidable as this one.
6: Don’t go with the flow
Oh no! You forgot to put the plug in the drain before you started washing your ocular, and it slipped out of your soapy hands and went down the drain. This is a scary moment, but if you’re quick, you might still save your eye from a watery grave. Under your sink there is a plumbing feature called a P-trap, also sometimes called a U-bend. The main purpose of this feature is to stop sewer gasses from coming up out of your drain and stinking up your house. It’s just a dip in the pipe in which water from your sink collects after you shut off the faucet, forming a simple, but effective seal. This means that in order to lose your prosthetic eye completely, it has to first go down into this trap, then back up a few inches before it begins its final journey to lost-ville. Since ocular prosthetics don’t float, it requires a good flow of water to wash them through the trap. If you are quick to shut off the water there’s a good chance it will be in there and no one need be the wiser.
7: Don’t drink and dr-eye-ve?
A general rule we give our patients for cleaning their oculars is to not put anything on their eye that they wouldn’t put on their skin. This generally means harsh cleaning chemicals like bleach or bathroom surface cleaners, but there is one gap in the rule that you should be careful of. Alcohol is often used as a disinfectant and is safe to use on your skin, so according to this rule it would be safe to use on your acrylic eye, right? Unfortunately, that would be a big mistake because alcohol attacks the acrylic and will create microfractures (crazing) on the surface. If the crazing isn’t too severe you might still be able to wear your eye, but it will definitely need to be replaced much sooner. More serious damage could include discoloration of the acrylic and enough surface cracks to make the prosthesis unwearable.
8: Avoid a wipe out
Although you know that you should avoid touching your eye as much as possible, sometimes it just has to happen. You might need to wipe up some discharge, clean some gunk off your eyelashes in the morning, or just have a gentle scratch in allergy season, but any of these actions come with the risk of dislodging your eye. Pulling your lower eyelid downward, or out towards your ear are most likely to unseat your eye. So as much as you are able, always wipe towards your nose.
9: Leave it to the professionals
Even if you never need to remove your eye, there is one piece of advice that will always apply to you and everyone else. That is to get your ocular prosthesis checked and polished by an ocularist annually. Everything might seem fine, but regular polishing will remove excess deposits and small scratches before they have a chance to cause you discomfort. Another benefit of a regular checkup is to spot changes in your socket that might require an adjustment to keep your ocular fitting and looking well, or even recommend a visit to your ophthalmologist to deal with something potentially more serious. Small changes over time can be hard to spot when you see yourself in the mirror every day. An ocularist who only sees you once in a while, and has older photos of you to compare, might see changes that you miss. And even if nothing needs changing and your socket is healthy, you will always come away with a twinkle in your eye.