Cleansing of the Hands: It should be noted that bacteria that frequently causes conjunctivitis and socket infections exists on the skin. It is therefore advised, that whenever handling the scleral ocular prosthesis, the hands should be thoroughly scrubbed, with emphasis on your fingertips.
Cleansing of the Eyelids and Eyelashes: Facial cleansing of the eyelids and eyelashes (with or without the scleral prosthesis in position) would require the application of a warm wet face cloth (with a 'no more tears' baby shampoo) to soften and remove any hardened secretion. The recommended baby shampoo will not irritate the tissues or the eyes since it has a neutral pH, and it destroys bacteria. Also, when it becomes necessary to wipe your eye with the prosthetic shell in position, remember to wipe toward the nose. The reason for this is to prevent rotation of the prosthesis, or cause it to fall out.
Cleansing the Scleral Ocular Prosthesis: Removal and cleansing of the prosthesis is a daily routine for patients who have a clear and sensitive cornea. Other patients who have a calcified and insensitive cornea or lack of a cornea have the option to remove it every other day or up to once a month.
The scleral prosthesis must always be cleansed immediately after it is removed. This is to prevent further drying of tears and/or secretion on its surface. Any of the solutions for hard or soft contact lenses may be used, however, this laboratory recommends the use of a soft wet face cloth with the 'no more tears' baby shampoo as the simplest and least time consuming method. Gently rub the prosthesis to remove any hardened protein deposits. (This would appear as a dull film on the surface when the shell is dry). Rinse well and check under a bright light, the prosthesis should have a glossy appearance.
Tears and Secretions: Since there has been an anatomical change within the orbit, the lacrimal duct may not function for the proper drainage of tears. It is, therefore, recommended that you carry a pocket pack of tissue with you, and use them when necessary to remove tears and secretions from the lids, eyelashes and/or the surface of the scleral prosthesis. The average amount of wiping is three to five times a day. Avoid the use of a handkerchief or the bare fingers.
If you have sinus, hay fever, asthma or a cold in your system, expect and increased amount of tearing and secretion. This is a natural experience. If the underlying tissue appears red (under the lower lid), rather than pink, it may require removal and cleansing of the scleral prosthesis three times a day until the secretions abate.
Periodic follow-up appointments should be scheduled for evaluation of fit, and to check for minute surface scratches which would require a re-glazing of the surface. This will be determined on an individual basis.