If your prosthetic eye feels dry or itchy, or if it feels like your eyelid is scraping against the prosthesis, this probably means you are not properly lubricating your eye socket. The question is, what will work better — eye drops or lubricants? And what is the difference between these anyway?
The reality is that everyone usually needs to figure out their own solution because our bodies and our environments are different. There is no one-size-fits-all answer to this.
But by reading this page, you’ll know what the problem is, what the possible solutions are, and where to get started. It begins by understanding what’s going on in your eye socket with your prosthesis.
Tear film layers — oil and aqueous
Your eyeball is protected by three layers of liquid called the ‘tear film.’ This is true of a normal eye or a prosthetic eye.
First, there is a mucus layer against the eyeball. Few people have the problem of insufficient mucus, since it’s your body’s solution to just about everything.
Next is the aqueous layer. This is a water-based layer and composes about 80% of the tear film. In dry, dusty, or cold weather, or as a result of dehydration, your aqueous layer can lose thickness, causing your eyes to dry out.
The outermost layer is the oil layer, also known as the lipid layer. The oil helps keep the aqueous layer intact, because oil and water don’t mix. But if the oil layer loses some of its thickness, the aqueous layer can escape more easily.
For healthy, comfortable prosthetic eyes, you need the appropriate thickness of all three of these layers.
What’s the difference between eye drops and lubricants?
Eye drops help restore the aqueous layer of the tear film, and lubricants help restore the oil layer. That’s the difference.
Since you need both layers to be present and thick enough, and because the body often has a hard time ‘accepting’ the prosthesis, both of these layers often need extra maintenance for anyone wearing a prosthetic eye.
Do we need eye drops and lubricants for prosthetic eyes?
The short answer is yes, but it’s not that simple, because that answer isn’t true for everyone.
Everyone’s body reacts a little differently to having a prosthesis. Some just produce fluids more easily, for example. Some are more easily hydrated than others.
In general, a healthy oil layer makes a longer lasting difference and will reduce the number of times you have to add eye drops. When the oil layer is the problem, using only eye drops will result in continuing frustration because the effects of the drops won’t last.
Climate is another factor. Hot and dry climates, extreme cold climates, temperate climates, living near the ocean — all these and other climates produce different environmental factors that can affect the tear film even in your natural eye. That’s why lots of people with two natural eyes still use eye drops!
Your workplace could be yet another factor depending on its environmental qualities.
Most people need both — eye drops and oil lubricants. But not everyone. Some people might only need eye drops. Others have found they need a different combination in the morning compared to the night.
This gets complex. For anyone with a prosthetic eye, finding out your ideal combination of eye drops and lubricants will require a little experimentation. Let’s get to the details.
Lubricant and eye drop options
For your aqueous layer, there are tons of eye drop choices. There’s blink lubricating tears, artificial tears, and other types of tears that are usually some form of saline solution.
Vitamin E is a natural oil, and many users find it very comfortable. But natural oils do tend to break down sooner than synthetic ones, so you’ll probably have to use it more often.
How to find your ideal combination of eye drops and lubricants
The key here is to change one variable at a time, and then keep the same routine for three days. That’s long enough to know if it’s working. If after three days your eye feels smooth and comfortable and there’s no scraping, dryness, or itching, and this feeling lasts for most of the day and/or night, then you’ve found a good combination.
If you have continuing discomfort, then you need to adjust one variable and try again for three days. This process could take a while, but once you find a system that works for you, you should be able to stick with it for many years.
The only way your solution could be upended is from big changes to things already mentioned like climate, hydration, or exposure to new places like a new job.
Here are the key variables to pay attention to as you search for your ideal mix of drops and lubricant:
- Brand of oil lubricant
- Brand of eye drops
- Number of drops of oil lubricant
- Number of drops of eye drops
- How frequently you use the drops and lubricant
The last thing that could interfere with this is an aging prosthesis. You need to get your prosthesis polished regularly. But if you go many months (or years!) without doing so, that alone will increase mucus production and cause other types of discomfort that your tear film will not be able to address. In that situation, no amount of experimenting will fix the problem, because the problem is the prosthesis itself.
So make sure you have your prosthetic eye cleaned and polished regularly.