Krishna Shah, M. Optom

Optometrist, Contact Lens Department, Sankara Nethralaya, Chennai

 

Introduction

Several misconceptions have been interpreted about people with disfigured eyes in general and about abnormal appearance of the eye. Those people have been conceptualised in different, often controversial ways since ancient times. It has been stereotyped and labelled by sighted people and has thus affected the acceptance of visually challenged people, the tolerance towards them and their integration into societal life. A person with disfigured eye or visual impairment is often presented as a personal tragedy, impaired body, or an individual misfortune, especially by policymakers and employers. Society has also often portrayed the visually challenged in negative lights, further increasing the negative attitudes against them.

Contact lenses are medico prosthetic devices used by over 150 million people worldwide. They are artificial devices applied on the front surface of the eye to substitute the anterior corneal surface. They aid in correcting refractive error of the eye, cornea irregularities and surface abnormalities. The idea of contact lenses was first proposed in 1508 by Leonardo da Vinci who gave birth to concept of neutralising the cornea by adding a new refracting surface. Primary applications of contact lenses include vision correction, therapeutics, preventive, diagnostic, cosmetic, and occupational.(1-2)

Figure 1: Various types of prosthetic contact lenses
[Picture courtesy : https://www.northwestfamilyeyecare.com/contact-lenses]

Prosthetic contact lenses are special lenses that cover the cornea in cases where the cornea has become cloudy or opaque. This special lens is made to match the other eye by enhancing the appearance of a deformed eye. A birth defect, disease process, damage to the eye, or other traumas like assault or chemical injuries like acid or alkali burns could be responsible for the eye, not appearing the same as the other eye. An individual born without an iris (aniridia), there will be a maximum amount of light entering the eye, causing sensitivity to light. Special customised prosthetic contact lenses are made to make an individual more comfortable, by reducing glare and blocking extra amount of light entering the eye.(3)

People who require these lenses may have congenital eye abnormalities, or they may have sustained traumatic injuries that resulted in some type of eye disfigurement.(4-5)

Indication of Prosthetic Contact Lens

  1. Cosmetic enhancement

Most people seek cosmetic benefits with prosthetic contact lenses. These individuals may have scar in the cornea, any congenital defects, or other different types of disfigurements. The visibility of these disorders can be significantly reduced with the use of the proper prosthetic lenses, giving the patient’s eyes a more natural appearance.

  1. A natural look

Prosthetic lenses not only hide the eye anomalies, but also help the eyes to look natural. From custom hand-painting to colour tinting, various techniques are available to make lenses that match the look, size, shape, and colour of own eyes.

Figure 2: A natural look with prosthetic contact lens in injured eye
[Picture courtesy : https://www.samyakeyecare.com/service/prosthetic-contact-lenses/]

  1. Reduces light sensitivity

Iris of the eye may sustain damage from an injury that causes the pupil to enlarge excessively, impairing the eye’s ability to adequately filter light. Soft prosthetic contact lenses can simulate normal pupil dilation and size significantly, which helps in reducing photophobia.

  1. Corrects double vision

This problem may be for the short or long term. Customized designed prosthetic lenses which incorporate a black pupil over one eye that blocks out light can correct double vision.

  1. Improves contrast and colour vision

Coloured prosthetic lenses can be useful, when a person is partially colour blind and are looking for solutions to improve their vision during sports events.

  1. Reduces glare

Simply defined, glare occurs when your eye cannot effectively control the excess light that is coming inside your eyes. Soft prosthetic contact lenses can be specifically designed to help in glare reduction, making your daily activities more comfortable and raising your overall quality of life.

  1. Improves self-confidence

These lenses can boost the sense of self-worth and confidence in interactions with others, which is one of its fewer tangible benefits. Prosthetic lenses closely resemble real eyes, giving you a considerably greater sense of self-confidence.

Conclusion

Besides providing better cosmetic than evisceration or enucleation, prosthetic contact lenses significantly improve the social relationships and well-being of patients. Prosthetic contact lens plays an important role in maintaining the integrity of orbital anatomy in case of disfigured or an absolute (blind) eye. Thus, prosthetic contact lens aid in enhancing cosmetic appearance and accelerating rehabilitation of people with disfigured blind eyes.

 

References

  1. Gurnani, B., & Kaur, K. (2022). Contact Lens–Related Problems and Complication
  2. Moreddu, R., Vigolo, D., & Yetisen, A. K. (2019). Contact lens technology: from fundamentals to applications. Advanced healthcare materials8(15), 1900368.
  3. Mitch cassel D,prosthetic eye options (2019) From scleral shells to custom soft opaque colored contact lenses…practitioners can make a difference,9(25),1900654.
  4. Wang, X., & Jacobs, D. S. (2022). Contact Lenses for Ocular Surface Disease. Eye & Contact Lens48(3), 115-118.
  5. Vegunta, S., & Patel, B. C. (2018). Optic nerve coloboma.