Ophthalmic Plastic Surgery, Orbit And Ocular Oncology Ocular Prosthesis Clinic

A precious life saved

Perhaps one of the worst nightmares for a parent would be to discover that their firstborn baby cannot see. But they can derive solace from the fact that their child's life was saved.

Little Rakshita was four months old when her parents noticed that her eyes seemed yellow and discoloured. A local ophthalmologist in Bangalore expressed his inability

to help and suggested that they seek more specialized treatment.

Dinesh Patel and his wife did not realize the gravity of the situation and it was several months later that they brought her to L V Prasad Eye Institute. The Ocular Oncology specialist discovered that the child had retinoblastoma in both her eyes. A hereditary malignant tumor of the retina, the disease is transmitted as a dominant trait and occurs chiefly among infants.

Unfortunately, it was too late to save her vision. A CT scan and bone marrow biopsy indicated that the child's life was at risk if the tumor (and the eyes) were not removed. The parents were reluctant to opt for surgery, fearing that it would mar the baby's appearance. But a visit to the ocularistry services convinced them the child would look 'normal', with the help of ocular prosthesis. Rakshita underwent an operation to remove the tumor in both her eyes followed by a series of chemotherapy sessions. She coped with the treatment well. She was referred for customized ocular prosthesis and, within a day, she was fitted with life-like artificial eyes.

An alert and active child, Rakshita is the apple of her parents' eyes. The only child in a joint family, she can sense and recognize family members and find her way around the house. Her parents have been counselled to bring her to the rehabilitation department so that little Rakshita can learn how to cope with her visual impairment and grow into a confident young girl.

The Ocular Prosthesis Clinic has created custom-made artificial eyes for babies as young as 13 days; the oldest patient to date was 97 years old.

Ophthalmic Plastic Surgery, Orbit And Ocular Oncology

Ocular Prosthesis Clinic

Ocular Prosthesis without downtime: A reality

Felix C Valenzuela flew into Hyderabad on 2nd March, 2006, with just a small backpack. He looked dazed and sleepless having travelled 20 hours non-stop from Mozambique. Originally from Columbia, he was a freelance negotiator primarily with the United Nations, solving conflict situations all across the world. His last assignment brought him to Maputo, Mozambique, where he now lives with his wife and two daughters. He continues to work as an economist and logistics/project management consultant.

Felix sought the removal of his disfigured eye following an accident but he did not want to end up looking like an "ogre", as he put it. Since there was no possibility of vision in the eye he not only desired quick surgery, but a quick prosthesis too! He had visited doctors in South Africa desperately looking for help. With no solution in sight he read about LVPEI on the Internet and finally arrived in Hyderabad.

After surgery the swelling in the area around the eye came down and the Ocular Prosthesis Department were able to fit an artificial eye for him. Felix was thrilled when he looked into the mirror - the custom made artificial eye looked real! When he boarded the plane home he had a smile on his face and an artificial eye in his pocket, which he would fit once the surgical scars healed completely.

A month later, Felix e-mailed to say that no one in Mozambique believed he was able to get everything done in less than a week! He added, "Just wanted to say thank you for everything - people still do not believe it is a prosthesis!"

The consultant plastic surgeon explains
At times, injury or infection can damage the eye so much that it cannot be treated in any way. Such an eye, in addition to being sightless, can also be painful and disfigured, requiring surgical removal. The empty socket is then measured by a wax cast, and replaced with a custom prosthesis (artificial eye) that looks like the real eye.

In most centres, the artificial eye is dispensed 6-8 weeks following surgery, because the swelling induced by surgery has to resolve completely before accurate measurements can be taken. The patient has to live a restricted life meanwhile, owing to the objectionable look of the empty socket. This also poses a disadvantage for out-station patients who need another visit.

The ophthalmic plastic surgeons and ocularist at L V Prasad Eye Institute have devised a novel technique to address this problem. Following removal of the eyeball, the ocularist takes the socket measurements while the patient is under anesthesia, before the swelling starts. The prosthesis is prepared while the patient recovers from anesthesia, and is placed into the socket the very next day!