The Ocularist: What to Expect During Your First Visit
On the first visit, the ocularist will measure your child's socket, look at the shape of the socket and match eye color. The conformer that was inserted during surgery is removed and is replaced by a temporary prosthesis. This temporary prosthesis is as close a fit and match as possible to your child's existing eye. The temporary prosthesis is used to help your child get used to wearing a prosthesis. In addition, it helps to shape the socket, and to aid in the healing and development of the socket.
Although this first visit may be emotional, it is not painful for your child. It may be helpful to speak with other parents who have been through this experience.
Caring for the Prosthesis
Adjustments to the prosthesis will be necessary as your child grows. How your child's prosthesis is fit and maintained plays a major role in the development of the socket. Without constant maintenance, polishing and necessary adjustments, their orbit will not develop and look like the natural eye. If the prosthesis is not properly maintained, your child may not have normal anatomical function or a good cosmetic result as an adult. The importance of having a proper fitting prosthesis for anatomical function and appearance cannot be overstated.
Parents are taught how to handle and clean the prosthesis. As your child grows up, he or she will accept the care of the prosthesis as part of the daily routine. Many children learn how to take the prosthesis out and put it back in on their own. For children under the age of 6, enlargements usually are necessary every 6-12 months. Polishing should be done at least twice a year. This can vary for each child. Cleaning varies from patient to patient. If the child has allergies or a cold, there may be an increased amount of mucus and the prosthesis will need to be cleaned more often.
The Conformer Came Out...Now What?
Occasionally a frantic parent will call saying, "that little plastic lens just fell out of my child's eye." That clear plastic piece is called a conformer, and although it is very important and needs to be put back in, it is not something to be afraid of. The conformer was placed in the socket after the eye was removed. It allows the socket to heal and form a space for the artificial eye, or prosthesis, to be inserted. It is not unusual for a conformer to come out or for your child to take it out. However, it is very important that it is placed back into the socket as soon as possible.
To insert the conformer, wash it completely with soap and water, and rinse it very well before reinserting. Raise the upper eyelid with the thumb of one hand and gently slide the conformer under the upper lid, just enough to make room to push the conformer into the socket and slide the conformer into place. Eventually you will insert the artificial eye the same way you inserted the conformer. As you become comfortable inserting the conformer, your child will be more comfortable and fitting your child with the prosthesis will be much easier.
The Importance of Protective Eyewear
Any child who has retinoblastoma, especially those with a prosthetic eye, should wear eyeglasses with polycarbonate lenses regardless of visual status. Polycarbonate lenses are made of the strongest available optical material used in protecting the vision of your child's eyes or remaining functional eye.
Due to certain orbital changes, vision defects can be made less noticeable using prisms that are added to the lenses, which may not be corrected by fit alone. Your ophthalmologist can guide you in identifying the appropriate protective eyewear and prescribe the correct lenses that are needed. Additional eye protection may be needed if your child participates in certain sports like soccer, basketball, football or tennis.
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