- POST-OP. CARE
During your operation your eye will have been removed and the volume lost in your eye-socket replaced with a spherical synthetic material similar to bone known as an orbital implant. The lining surface layers of the eye-socket are stitched over the implant and then a small clear plastic shield called a conformer is placed in front of the stitched tissue and behind the eyelids. This maintains the shape of socket recesses (under your eyelids) and provides a little protection for the healing tissues.
After your operation
What will the socket look like?
Usually the socket will appear a little more closed that it did before the operation. Between the eyelids and lashes the conformer (clear plastic shield) covers the socket tissues. These tissues are not usually very noticeable to the casual observer but if inspected appear similar to the inside of your lower lip when everted. Whilst clearly an eye is not visible, the appearance, due to the lids being slightly closed is neither alarming or greatly disfiguring. It is best to leave the socket open to the air and not to cover it over if you can and most people have no problem in this regard. If however, you wish to cover the socket please use a vaulted eye-patch that does not lie upon or touch the eyelids – in particular do not apply a pad to the eyelids as this may result in contamination and infection of the socket.
Whilst your eye may have been removed to eliminate discomfort, it is not uncommon for the socket to feel quite sore for the first 2 or 3 days. However, this usually passes quite quickly and the socket becomes comfortable and any pre-operation pain / discomfort is usually quite quickly gone but like all things this varies from person to person and is usually a reflection of the condition of the eye at the time of surgery.
If you experience any discomfort during the immediate post-operative period, take a pain reliever such as paracetamol or co-dydramol (which may have been prescribed) every 6 hours. Please try to avoid aspirin, unless of course it forms part of your regular prescribed daily medication. You may however, take ibuprofen or a similar non-steroidal anti-inflammatory drugs (NSAIDs)
Discharge from the socket?
Some spotting of blood or minor oozing is not uncommon within the first few days / weeks following your operation. Use a clean piece of paper kitchen towel if necessary to clean the eyelids if needed using a solution of cooled boiled water with bicarbonate / salt (1 teaspoon of sodium bicarbonate or salt dissolved in 1 cup of cooled boiled water).
Your can use a similar solution to clean the eyelids at other times (e.g. mornings) if they are a sticky and stuck together.
Medication for the eye-socket
Following your operation you will be prescribed an eye ointment which is to be squeezed gently onto the surface of the conformer (clear plastic shield) and along the lower eyelid. The conformer usually has 2 small holes in it, if you can, try to squeeze a little ointment through one of them so that it gets to the surface tissues behind. The doctors and hospital staff will explain how to instil the eye-ointment and you will usually be asked to continue to use the ointment until you have been reviewed in the clinic 10-14 days later. The eye-ointment is important to keep the socket clean and to reduce inflammation. If you should run out please contact your General Practitioner to obtain some more as soon as you can.
You will usually also be prescribed a short course of oral antibiotics in an effort to reduce the likelihood of developing an infection. Please endeavour to take the full course as prescribed.
The conformer (clear plastic shield)
The conformer is to be left in place until you are shown how to remove and clean it at your first clinic review which is usually 10-14 days following your surgery. Should it fall out, if you inadvertently rub your eye socket for example, then it should be replaced. To replace it you first need to wash it thoroughly with a little soap and hot water and then to dry it with clean tissue paper making sure all the soap is removed. It is then merely a matter of holding the edges between finger and thumb and sliding it under your upper eyelid whilst gently pulling down upon your lower eyelid so that the bottom edge can enter the socket once more. Place a little of the ointment with which you will have been provided, in the socket once it is back in place.
All of the stitches used are intended to dissolve of the their own accord. The rate at which they disappear varies a little but you can expect to find the occasional blue fragment of stitch exiting the socket 2 - 4 weeks after your operation.
Healing and Dos and Don’ts
In most cases, healing is essentially complete in about 6 weeks.
For the first 2 weeks whilst your eye is healing, it is advisable to avoid bending, lifting, straining, or strenuous exertion. You should also do your best to avoid dirty environments and rubbing your eyelids. Otherwise you may go about your customary activities including reading and watching television etc.
You may drive provided that you were driving prior to your operation AND had fully adapted to any previous loss of vision. However, if you have had a sighted eye removed or have not fully adapted to your previous visual loss, you MUST NOT DRIVE until you have completely adapted (come to functional terms) with the loss of your vision.
When will I received my Artificial Eye?
You will normally be reviewed in the eye clinic about 10-14 days after your operation where removal, cleaning and replacement of the conformer will be explained / demonstrated.
You will need to remove, clean and replace the conformer and later your artificial eye, on a weekly basis. However some people need to do so more frequently and whilst this is not a problem, the additional stretching of the eyelids that is entailed can over time result in some laxity or sagging of the eyelid.
After the course of post-operative eye-ointment is finished, you will be provided with a tear lubricant that you may apply to the conformer / socket / artificial eye whenever required to keep it comfortable and mobile.
You will usually be sent an appointment to see the Artificial Eye Service (AES) about 6 weeks after your operation. At this point the stitches have usually dissolved and most of the swelling within the socket will have settled. You will usually be provided with an “off the shelf” artificial eye (prosthesis) at your first visit, which will be matched to your other eye. The AES team will decide when the time is right to take an impression (a bit like the dentist) of your socket in order to fashion a custom artificial eye. Your artificial eye needs to be looked after in exactly the same way as that of the conformer.
The AES will maintain and change your artificial eye periodically as is required – usually you will need to have the prosthesis checked every 6-12 months.
As a general rule, it is a very good idea to have either a conformer or your artificial / prosthetic eye in place at ALL times to prevent socket contraction.
Advice / Help
If you have any problems or concerns you should contact Mr Shuttleworth’s secretary (01792 391122), the Sancta Maria (01792-479040) or alternatively your General Practitioner.