Post-enucleation socket syndrome (PESS) : A combination of effects caused by shrinkage of the orbital tissues
following eye loss - depleted orbital volume, upper lid ptosis, and lower lid laxity.
Upper lid ptosis : Drooping upper lid.
Lower lid laxity : Drooping lower lid.
Upper lid entropion : A inward turning of the upper eyelid causing the eyelashes to point downward and stick
to the prosthesis.
Most artificial eyes look good and cause very little trouble in use. Sometimes however, the socket is distorted due to scarring or through recession of the eye socket over time. These 'difficult sockets' present a challenge to the prosthetist and to the oculo-plastic surgeon. Surgical procedures provide more scope for improvement than modifying the prosthesis alone, but they too are often constrained by pre-existing conditions.
The best outcomes are obtained when surgeons and prosthetists adopt a team approach to the problems and build
upon each others' contributions. Beyond cosmetic surgery It is not vanity that motivates anophthalmic patients to seek cosmetic surgery but a simple desire to blend naturally into
the community - just like the rest of us.
References for these procedures :
Chen W. 2001. Oculoplastic Surgery the Essentials. Thieme, New York.
Collin J.R.O. 1989. A Manual of Systematic Eyelid Surgery. Churchill Livingstone.
Collin R. & Rose G. 2001. Plastic and Orbital Surgery. BMJ Books.
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