Tuesday, January 8, 2008

Allelujah!





Yesterday we met with the man who will one day make my prosthetic eye! He was so nice and made us feel so much better about everything. His name is Daniel Wenske and he too only has one eye with vision. He lost his eye when he was four years old and that inspired him to become an ocularist. (An Ocularist is a health professional who specializes in prosthetic devices for the eye. This specialty combines an understanding of color and artistry with expertise in the science of the development and function of the face and eye.) I can't believe that we are finally meeting with someone who understands my condition and has seen many kids with microphthalmia and anophthalmia (the absence of eyes). This is the first time that we haven't felt like we were educating the doctor... we were finally in the right office. Mr. Wenske is eager to get things started on me because I am growing so very fast (I'm up to 10 lbs. already!). The first steps that must be taken include inserting a conformer into my eye. This is basically like an expander for my orbit or socket.

Here is some information from the website I mentioned earlier, it is very informative...

The orbits (eye sockets) are very important for proper growth and development of the face. If an eye is missing or too small, the bones around the eye may not grow properly. A conformer is a plastic shell-like device made by the ocularist that can be placed inside the orbit to help support the growth of the eye socket and the bones in the face. As the child grows, and the orbits and facial bones develop, the ocularist can also make prosthetic (artificial) eyes. Since each child is different, the age when the child is ready for a prosthetic eye varies. The ocularist works closely with the ophthalmologist and oculoplastic surgeon to make conformers and prosthetic eyes that are best for the child. Sometimes surgery may be recommended to implant a prosthetic device deep into the orbit in order to make it easier to fit the prosthetic eye. There are various surgical options available when the conformers are not enough alone.

There is no treatment that can reverse microphthalmia. It should be monitored according to the complexity of the eye involvement. If the eye is small or badly malformed, then an artificial eye or lens (sometimes called a scleral shell or prosthesis) can be fitted for cosmetic reasons and/or for promoting socket growth.

In infants, a prosthesis or conformer generally must be enlarged every few months to expand the socket. This is necessary to stimulate the socket tissues and bony orbit to grow at a normal rate. In the case of a congenitally small orbit, the socket and lid opening is actually smaller than the companion eye. Because of this difference in size, a series of conformers are necessary to stretch the tissues and form a socket into which prosthetic eye can later be fit. The conformer is usually enlarged once a month (weekly according to Mr. Wenske) or as necessary to increase orbital volume as circumstances allow.

As the child grows the prosthesis will need to be checked regularly for size, comfort and fit (usually 2-3 times a year). It also needs to be polished and checked for any damage such as scratches or sharp edges.

When a child’s eyes are fully developed, usually by the preteen years, the prosthesis will generally remain the same shape and size for a longer period of time. However, it is necessary to enlarge the artificial eye periodically or fabricate a new prosthesis from time to time. Depending on he child’s age, this will need to be done every 3-5 years.

If the microphthalmia is unilateral and causing reduced vision in that eye, then the ophthalmologist should prescribe protective glasses with polycarbonate lenses to protect the better eye from injury.

So you can see that this is a long process for us and we'll certainly get to know our ocularist quite well. My mommy took some pictures of our visit. You can see his desk where he'll actually be making my eye one day! Pretty cool huh?

Mr. Wenske decided that it would be best for me to be put to sleep before my exam is done and for the insertion of my first conformer to prevent trauma for me and my parents! It's not painful, but rather just hard for me to relax and remain still for the procedure. This will also allow Mr. Wenske to look inside and get a better feel for what he's working with. We will be meeting with Dr. Fry on Thursday, January 10 - she will be the ophthalmologist who will put me under for the procedure. We aren't sure if the procedure will be done this day or not, we'll keep you posted.


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