When someone first starts wearing a piece, there is an accommodation phase. The eye is not used to receiving stimulation from the surface of the eye, and when it is stimulated by the touching of the prosthesis to the eye, initially the brain communicates that as pain, simply because it’s not used to the sensation. As the eye starts to accommodate the shape, the sensitivity decreases and the piece gets much more comfortable. Eventually, it will go completely unnoticed.
Another reason the eye may be uncomfortable for the first time is that the initial impression needs to be altered and refit. Even though impressions are taken straight from the eye, once the piece is inserted we have the best possible idea of just which modifications need to take place — perhaps there is too much space on the top, or we need to take pressure off the cornea.
In most cases, we have patients wear a temporary fitting piece for 2 weeks before they wear their actual artificial eye. That gives time to settle or make changes as necessary. When you put the shell in for the first time, it will feel quite uncomfortable for the first 30 seconds or so. Within 5 minutes, it feels 90% better.
The first evaluation of fit is done in our office where patients wear the piece for an hour. If they can do that, then they try sleeping with it. Once that is done, they try wearing it 24/7. And once that is achieved, the person can wear it year-round with the exception of important biannual cleanings.
When wearing a piece in the first few weeks, it is important to pay attention to little sources of discomfort. These may be small flaws in the piece that can be completely remedied simply by notifying the ocularist. Don’t rub the eye too much — that can cause its own inflammation and irritation, causing what otherwise would be fitting properly to be uncomfortable. Simply try to leave the piece alone — let it function like a natural part of the body rather than an artificial part of the body. It is important to let the piece accommodate itself to your own anatomy. By leaving it alone, that can desensitize and bring comfort to the prosthetic eye. If discomfort persists, be sure to tell your ocularist so that he can make the necessary modifications to your piece.
When it comes to fitting an eye, some cases are simple and straightforward, while others are complex and can take up to 6 months to properly accommodate the piece. In some extreme cases, people may need surgical intervention to desensitize nerves in the eye so that they can wear a piece in comfort.
We take our time in the evaluation period to make sure things are working properly and that is one reason we make eyes that our patients consistently say are the most comfortable eye they’ve ever had. We like to tell our patients that wearing a prosthetic eye for the first time is a bit like a new pair of shoes — as you wear it, it breaks in and gets more and more comfortable. In this case, though, your ocularist is like your own personal shoemaker and he can help get the most perfect fit possible. We look forward to hearing from you today to discuss how we may be able to help!