A Prosthetic Eye, Antibiotic Ointment, and a Cautionary Tale

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A Prosthetic Eye, Antibiotic Ointment, and a Cautionary Tale

Unread post by OneEyedMichigander » Fri Apr 13, 2012 11:29 pm

As I mentioned in my intro post, and in a subsequent reply, I just got a new prosthetic yesterday, as I had issues with how the eye fit. Anyway, it turns out I may have caused the eye not to fit, so I figured I'd offer a bit of a cautionary tale. I may be preaching to the choir here, but for anyone not aware, here's a little story about why one needs to be careful with antibiotic ointment.

I have erythromyacin ointment for when the socket gets gunkier than usual. There's almost always some gunk, but my ophthalmologist gave me the erythro for when it gets gunkier, indicating possible infection.

Well, around the end of February, it was pretty darn gunky. So I decided to use the ointment. I got what I thought was a really good idea. I decided I was going to show what infection was present who was boss! So I took the prosthetic out, put it in soapy water, and packed, and I mean packed, the socket with erythromyacin. A couple times a day.

I put the eye in a couple days later to go outside to meet my mom in my apartment parking lot, and she thought something just didn't look quite right. Figuring it might be related to whatever infection may have been present, I took it back out and kept packing the socket. Boy oh boy, was I ever gonna show that infection who was boss!

About eight days later, I put it back in. Took a few minutes to get it in, and it was definitely not right. I did have an appointment scheduled with the ocularist for March 30th, but my mom and I talked and decided that the ophthalmologist needed to have a look, as evidently there was some infection causing inflammation that wasn't responding to the erythro. So the next morning (March 1st), I saw one of the docs at my ophthalmologist's office.

Surprisingly, he didn't think it was infected. He thought it was either a lubrication issue, and suggested I ask about lubricating drops when I saw the ocularist, or a fit issue, and the eye may need to be modified or replaced. He did give me a different ointment just in case.

I had a regularly scheduled right eye check March 20th with my regular ophthalmologist. At this point the prosthetic would. Not. Fit. At. All. Just wouldn't stay in. Wouldn't *go* in. I tried, and he tried, but no dice. He agreed with the doctor who saw me on the 1st that it didn't seem infected. He said (as the other doc said) sometimes the tissues change over the years.

So I went to the Ocularist on March 30th. I told him about how I thought there was infection due to an increase in gunk. I mentioned how I had the eye out and was packing it with ointment. He asked what ointment. Erythromyacin. He asked if I'd been instructed to pack it. I said no, that was my idea. His response?

"Okay. Well, you might not want to do that."

He explained that erythromyacin has a tendency to cause tissue shrinkage. Moreover, having the eye out for so long means the tissues don't have anything to conform to so that can also cause changes. Turns out that I was due for a replacement anyway, but at least now I know that while I thought I was showing whatever infection may have originally been there who was boss, it could very well be that the erythromyacin was showing ME who was boss!

So, just thought I'd share. If you have antibiotic ointment, particularly erythromyacin, and you get the bright idea to pack your socket with it...it's probably best that you don't. Also having the prosthetic out for extended periods is also evidently not helpful.
Age: 28
Born with:
Microophthalmia with coloboma in right eye, cataract removed at 17, 20/200 vision, treated for but haven't lost vision from glaucoma
Anophthalmia in left eye, prosthesis since around infancy
Incurable and Untreatable Sense Of Humor

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Re: A Prosthetic Eye, Antibiotic Ointment, and a Cautionary

Unread post by Moby » Sat Apr 14, 2012 12:25 am

Some "gunk" is normal, but if the colour gets dark yellow or greenish is the time for antibiotics. Remember not all bugs need drugs. A great reminder Lauren. Many thanks for sharing.
F/ Amblyopia, intra-ocular lens both eyes, cornea transplant, blind in L/Eye due to retinal detachment.Glaucoma. Capsulotomy seeing eye.
Seek someone who communicates with you in laughter for laughter can turn a sad day into a joyful one.

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Unread post by Willis » Sat Apr 14, 2012 3:45 am

Good Tip, Lauren. Society is inculcating us with the credo that bigger is better and more of anything is a rule to which all should adhere. You just fell prey to the mindset fostered by Madison Ave.

Sometimes, more, bigger or "super-size it" aren't blessings :shock:

68/M/Vehicular Mishap/1969
Willis Nowell, Humble Webservant of:
Shannondale and Beyond

Willis passed away on January 3, 2017.
He will be missed.


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Re: A Prosthetic Eye, Antibiotic Ointment, and a Cautionary

Unread post by Lorry » Sat Apr 14, 2012 5:11 am

Wow, thanks for sharing this Lauren. Kinda sounds like something I would do. And now that you have, I won't.
I am pretty new at having an eye socket with prosthesis. I have had no issues since enucleation and I sure would like to keep it that way.
I am glad it worked out for the best for you.
Lorry / F / Lost Rt. eye retina detachment 2004
Enucleation Rt. eye Feb 1 2012
Wearing new eye Mar 28 2012

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Re: A Prosthetic Eye, Antibiotic Ointment, and a Cautionary

Unread post by cslonim » Sat Apr 14, 2012 4:46 pm

your ocularist was correct on 2 fronts: 1) more erythromycin ointment is no better than a little and 2) prolonged absence of your prosthesis can result in some shrinkage of the socket. however, i might challenged his/her claim that erythomycin ointment has a "tendancy to cause tissue shrinkage".

regarding a little ointment - as with any socket infection, the source of bacteria is typically on the conjunctiva. once the gunk/pus/gooey stuff is removed, only a thin film of the antibiotic ointment (1/4 inch) is needed to coat the surface of the socket conjunctiva and kill the bacteria (assuming that the bacteria is not resistant to the chosen antibiotic!). this assumes that the gunk which will contain a load of bacteria has been rinsed away.

regarding prolonged absence of your prosthesis - this means more than just a few days.

regarding erythromycin and conjunctival shrinkage - i am unaware of any scientific evidence that supports this claim. erythromycin is a great antibiotic and one of a few ophthalmic antibiotics that come in an ophthalmic ointment form. it has a broad spectrum of activity (kills a lot of different bugs) especially those known to hide in the eyelids and lashes. i would hate for the losteye readership to worry about their sockets if their ophthalmologist prescribed erythomycin. good luck.
oculoplastic surgeon
tampa, florida

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