prosthetic eye

[DivingDoc]

My son-in-law had an eye removed the summer before last (He never had been able to see out of the eye since birth). The eye was replaced by a porous ball, which was attached to the various eye muscles (so it would move with the other eye) and covered with the bulbar conjunctiva (that previously lined the eye socket. The site was allowed to heal and during this process, blood vessels grow into the "ball," so it effectively becomes part of the body. The surface of the new "eye" is then fitted with a sort of large custom-molded and acrylic "contact lens" which is painted to look like the other eye.

His eye surgeon has cleared him to dive. Currently he is taking a PADI open water course. The pool is 10 ft deep and so far he as noticed no pressure sensations in the tissues around the eye.

We are planning to take the whole family, including him, down for a week of diving in Cozumel in May.

Is he likely to have any problems I haven't thought of?

 

[eandiver]

I'm way out of my league with the spelling and medical terms but I'll give it a shot.

10/02/90 I had my left eye surgically removed due to it being destroyed by an exploding auto tire. There was not enough "bulbar conjunctiva" to retain the ball as it extruded several times after surgerys. The rear of my prosthesis is molded to the flesh of my socket which gives it limited movement. I started diving in 2001 and have never noticed any problems except for pool training where the chlorine made the socket burn.

If you clear your mask correctly and often wouldn't that take care of pressure problems?

Keep in mind I am still a "novice diver" though.

 

[DivingDoc]

eandiver once bubbled...
I'm way out of my league with the spelling and medical terms but I'll give it a shot.

10/02/90 I had my left eye surgically removed due to it being destroyed by an exploding auto tire. There was not enough "bulbar conjunctiva" to retain the ball as it extruded several times after surgerys. The rear of my prosthesis is molded to the flesh of my socket which gives it limited movement. I started diving in 2001 and have never noticed any problems except for pool training where the chlorine made the socket burn.

If you clear your mask correctly and often wouldn't that take care of pressure problems?

Keep in mind I am still a "novice diver" though.

Hmmm -- very reassuring. How deep have you gone?

The sorts of potential problems I was concerned about was more whether there might be any self-contained air pockets around or in the surgical site. If they did not communicate with any spaces outside the body, you could have a problem -- similar to the sinus squeeze that occurs when your sinuses are plugged up. The air pressure in the sinuses stays at sea level pressure while the water pressure around the diver increases with increasing depth. If the "drainage holes" for the sinuses are plugged up, the air in them cannot equalize with the air in your mask, producing "sinus squeeze."

Another potential problem that I could think of is the same as could occur in any surgical site. Scar tissue may not be as well vascularized as normal tissues. Thus, nitrogen would be more slowly eliminated from such sites, potentially causing a localized case of "the bends."

Any thoughts?

 

[eandiver]

110' is the deepest I've been.

If there were any air pockets would they be big enough to cause serious problems if they rupture or just bleed a little.

I'm assuming you are a doctor? (no offense) If so do you and your son in law have access to an area that can allow you to dive to approx 60'?
If so once he has finished his certification go out and do a slow decent to that depth and monitor his eye for any pain or bleeding.

As far as the nitrogen goes I don't think there would be much chance of a problem in that area.

Have you ever heard of anyone having pain in scar tissue due to nitrogen build up?

 

[Walter]

If there are any pressure issues they will be discovered in shallow water, likely in the first 10 feet certainly by 20 feet. DCS issues are the same as for anyone with old injuries (almost all of us). Dive very conservatively. Ascend slowly, make long stops on ascent.

 

[DocVikingo]

That this chap has received clearance to dive from his surgeon is probably the best indication of what is to be anticipated.

Based on Boyle's Law, the biggest worry for scuba with a prosthetic eye is that a hollow one or one containing air pockets has been implanted.

Aside from that, a diver should manifest adequate visual function & acuity to carry out the basic demands of scuba. S/he should also be free of distracting pain.

Consistent with what Walter has stated, remember what we know about pressure changes with depth. If you're going to experience adverse events from increases or decreases in pressure, it's very likely that you'll notice these within the first atmosphere under the surface. Compared to this, the atmosphere between, say, 66' to 99' is relatively trivial.

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

Best regards.

DocVikingo

 

[Lloyd]

I teach in this area and feel that if the surgeon signed him off he is ok. Any air pockets should be absorbed in a few days. As others have pointed out, the greatest pressure change occurs at the beginning of a dive.

Concerning nitrogen in the tissue. Yes it is possible in theory, but is very unlikely to cause any harm since the tissue is none functional and the bubbles will have a hard time migrating because of the reduced vascularization.

Now for the usual. This is for education, not specific medical advice.