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The Art of Ocular Prosthetics | The Eye Believe Podcast · The Eye Believe Podcast

0:03
hey everybody welcome back to the Eye Believe Podcast
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I'm your host Danet and today I'm joined with Sara Moslehi
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who is an ocularist and an anaplastologist
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at Art in Soul Prosthetics in Lakewood Colorado uh
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Sara actually reached out to me I think via email
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and she was interested in chatting and just um
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helping add value to the Eye Believe podcast
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here for ocular melanoma patients
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um so Sara thank you so much for joining us
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good morning Danet thank you so much for
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inviting me to the Eye Believe Podcast it is my pleasure
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to have this opportunity to talk about
0:35
um prosthetic eye rehabilitation today
0:38
yeah no I'm super excited um
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for those of you guys who don't know I'm also an ocular
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melanoma patient and I also have a prosthetic eye
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it was not made by Sara but
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um it was made by a very skilled ocularist and so um
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I I honestly like as a as a monocular patient myself
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I think that the
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artistry and the skill that goes into creating
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prostheses um and also like
1:01
um there's not very many people in our in our
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in our field of you know ocular
1:05
melanoma who I know who have like a full
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um like facial prosthesis where it's like
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filling you know like the
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if they had to have the socket
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kind of changed out and like
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but it's incredible to me like the way that
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um people like you can can create these like
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beautifully functioning and just like matching and
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honestly it's it's just a really empowering
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thing I think for patients so
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anyway before we get into all of that
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can you tell us a little bit about how you found your way into this work
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and really like why were you drawn specifically
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to ocular um or ocular ocular
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ocularistry is that how you say it yes that's perfect
1:45
and anaplastology and honestly
1:48
feel free to tell us the difference
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between those two words
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cause I don't think most people know what anaplastologist is
1:53
sure um
1:54
Danet I came into this profession through my father
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Iraj Moslehi he dedicated his professional life um
2:01
in designing and fabricating
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custom ocular facial and somatic prostheses
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um he introduced me to this um profession and I um
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started um I began learning from him um many years ago
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um what was so fascinating to me what
2:19
from the beginning was how many different disciplines
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come together in this field
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there's anatomy there's a sculpture medicine
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painting color theory uh technical precision
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and problem solving
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but at the center of all of that is the patient
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if I wanna say uh
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tell you about the different between
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uh ocularist and an anaplastologist
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um an ocularist specializes specifically in custom um
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ocular processes and sclera shell um
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and anaplastologists uh
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work more broadly
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to make um all types of prostheses including ocular
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facial and somatic prostheses like for example ears
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nose fingers
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toes or any other parts of face or body prostheses
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um
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what has kept me in this profession all these years um
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is that we are not simply
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replacing anatomy we are helping someone um navigate
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a change in how they see themselves and sometimes how
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um they feel being seen by others so um
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and I have been um
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working in this field for more than 18 years now and um
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this is just I can say my passion
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oh I think it's so neat
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when I hear about people who have gotten into this field
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um as a result
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of like you know kind of like a family background and so I
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I actually I don't think I knew that your father was um
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a part of the reason
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that you were able to go into this practice so
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I mean I just I think it's such a a unique um skill set
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and honestly like I mean I can't I can't complain
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that people
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figure out how to do this um because obviously
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like people who lose an eye to
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cancer or you know various other causes of um
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like losing an eye like it it would be pretty
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important to have someone who knows what they're doing there
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um okay so
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Sara
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thanks so much for like giving us kind of a little bit more of your background
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but I kind of want us to kind of
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follow a little bit of a flow as we chat here about um
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like obviously you know you end up with patients
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who sit in your office and by that point
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most of the time I I I guess my understanding
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from my process was that
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you know I would meet my ocularist maybe like
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after I had surgery um but um
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there's obviously like
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some benefit to potentially meeting
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with someone like you ahead of surgery
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which I kind of regret not doing earlier myself
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um so let's just kind of back
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back track a little bit like in the patient journey I
5:00
suppose of losing their eye
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um and let's talk like before surgery so
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if a patient is sitting in front of you
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they've been told like they're going to probably
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lose their eye for one reason or another um
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what are some of the things that they're
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gonna be worried
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about and maybe that they're not being talked to um
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like within the medical scope of things
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sure um when someone is first told that they um
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may lose an eye the medical conversation
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which is completely understandable um
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it's more focusing on the disease the surgery
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um their health and sometimes even survival
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so but there is another very important question
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sitting quietly in the patient's mind
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what am I going to look like after all this
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and sometimes they almost feel guilty even asking
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about it talking about it
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they may think that I should just be grateful
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that I'm alive right now or I shouldn't
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care about my appearance
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caring about your appearance um does not make you
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um that you are
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does not make you sound like you're vain
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or you are being ungrateful
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our faces are such an important part of our identity
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and how we communicate with other people
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eyes are especially connected to expression
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um and human ex
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uh uh connection so these are very important
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so patient may be worried about
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whether they will still look like themselves whether
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other people will notice whether they will be
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stared at whether they can go back to work
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or even whether their spouse or children
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will look look at them differently
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so those concerns deserve to be acknowledged too
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yeah honestly like it's one of those kind of
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crazy things I think that I
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I think because we have ocular melanoma
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like in in our patient demographic um
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it's kind of one of those things that like
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not everybody really thinks about until suddenly
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like you're faced
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with the fact that like the appearance of your eye
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or your face is going to change in some way um and
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and like you said like a huge piece of that is survival
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right like we we do need to treat the cancer
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um so we can't necessarily avoid whatever
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treatment is going to look like be it enucleation
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or radiation um
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but those appearance changes like I
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I like what you said about like the
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the kind of the the guilt right maybe like and
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and just kind of honoring
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the fact that like it's okay to care what you look like
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um and to want to know like and have some kind of
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confidence going into the surgery that like
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there's something
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after this and that it's not just oh my gosh I'm gonna have an eye patch and
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like I'm not gonna know what I'm gonna look like
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like all of those questions come up I'm sure um
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I know we kind of mentioned a little of this but like talking to an ocularist
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before surgery what could that conversation look like
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um especially like if someone you know hasn't actually
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gone into surgery yet and
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we're catching them and they're listening right now um
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like what what is the benefit of potentially
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talking with someone like an ocularist ahead of time
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um I think meeting with an ocularist
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before the surgery can be actually very helpful
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not because the ocularist
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um is there to influence the surgeons medical
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um decisions those belongs to surgical team
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but because we can answer so many questions
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um what happens afterwards
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when people don't know what comes
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next their imagination can fill that space
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with usually with the worst possible picture
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I can explain that the healing process um
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what does it look like um regarding
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a prosthetic perspective
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um when um we be um typically become a
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uh involved what an ocular
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uh prosthetic is how does it make and uh
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what everyday life uh
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with the prosthetic uh will look like
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I can answer so many questions that uh
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they're already in their mind or it just comes
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right after we we start uh having this chat uh
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sometimes just knowing that there is
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another step after surgery
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makes the whole situation feel um
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a little less overwhelming that's what I think
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yeah I mean honestly I was so overwhelmed myself
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like going into surgery because it was very sudden
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for me and so you know I feel like
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this is one of those things where like if you're listening
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please please consider doing it differently
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than maybe some of us have had the experience of doing
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um you know consider
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chatting with an ocularist or you know feeling out
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kind of maybe shopping
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around I don't know like that's probably kind of hard because I don't
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like sorry
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correct me if I'm wrong but I don't think there's very many of you guys in the whole like country
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um there's a
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very select few want to stay with your local um
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ocularist and if if they're available
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yeah absolutely um
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but I mean I've obviously
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like I know people who have traveled
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like who have gone clear across the country
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because they have an ocularist
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there that they like and um and
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I mean that's that's definitely
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something to think about
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um but let's clarify the surgeries
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because in ocular melanoma like
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we typically hear about like enucleation
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that's kind of the main the main one that we hear about
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um but I know that these words
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can be a little bit confusing
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for patients so for those of you guys listening
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we're gonna chat and just kind of
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let's define the difference between enucleation
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evisceration
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and an exenteration is that how you say the last one
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Evisceration exenteration okay yeah so let's define
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that like what is the difference and why does that distinction
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matter for like what comes after so Danet
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these words sounds very similar
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especially when you're going through all this
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stressful medical experiences
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um the simplest way I can explain is that um
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with an evisceration the contents
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inside the eye is removed
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but the outer white shell of the eye is preserved
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with an enucleation
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the entire eyeball the globe is removed
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but the surrounding orbital um
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tissue and structures um will remain
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um with both of these um
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procedures the surgeon will commonly place an um
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place an implant deeper in the socket
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to keep uh to help restore the volume that was lost
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the implant
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is different completely different from prosthetic eye
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the implant is surgically um placed in the socket um
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underneath the tissue the ocular prosthesis
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is a very uh is a removable piece which goes over
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the implant um if I wanna explain Exenteration um
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this is much more extensive surgery
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it involves removal of the entire eye
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along with other um
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uh additional tissue of the orbit the amount
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removed can be
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and can be very different depending on the
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disease or the surgery they had or any
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medical necessary that they need to remove
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more or less uh part of the orbit
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uh that distinction matters
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because the prosthetic rehabilitation
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could be very different afterward
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okay so thank you so much for defining the difference
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there because like you said like those words
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all sound so similar
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and I feel like it could be really easy to confuse them
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and especially if you like are confusing them in the wrong direction
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and you think that maybe you're having an evisceration
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instead of an enucleation like
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it would be important to know like the difference um
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especially for you know what comes afterwards
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in the in the prosthetic um creative process so
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obviously you mentioned like there's a period
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where the the the body is gonna need to heal
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after surgery but let's just assume
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that somebody's been in they've chatted with you
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um they they know kind of what to expect and um
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I guess for the sake of simplicity let's maybe
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stick to like the enucleation process
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just cause that's probably the most common
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for ocular melanoma patients who might be listening um
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so once they've healed enough to actually
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start the process of making their prosthesis
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what actually happens
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like when they walk into your office
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for that first appointment
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so um Danet the first appointment is
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very much more than just looking at the
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color of the eye uh before I make anything
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I want to understand the patient
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their story their medical history
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what they have been through
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um how much they have healed and what they are uh
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hoping to regain those are very important so
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I um start the conversation we um
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um I keep um telling them
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that if they have any question just you know
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feel comfortable to ask and
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the first appointment is usually start with that and um
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sometimes even on the first appointment
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it's just all about consultation we don't
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we we are not at the point to start the process
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but um if um everything has been take
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care of and the patient is good to go and they're ready
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um for the prosthetic
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then I start evaluating the socket and the surrounding
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tissue I look at so many things at the same time
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the space shape tissue movement eyelid position
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symmetry and
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how the anatomy behave when the patient looking
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different directions um people often think that um
15:04
and an eye is
15:06
like just the color of the eye is just
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brown blue or green
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but it is not when you are trying to recreate
15:13
one specific person's eye
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that is not nearly enough um
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I also study the the other eye very carefully
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and I evaluate Iris size pupil size
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pattern within the Iris
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sclera color all those blood vessels gaze
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eyelid opening so many things
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at the first appointment and I'm
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at the same time I'm listening to the patient
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as I'm going through the process
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I mean it's
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such a unique process having been through it myself
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um and and I think that was probably one of the most
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surprising
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things to me the what you mentioned about the color
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like I have blue eyes so I was like well you're gonna just paint
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blue right and he and my ocularist
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told me actually no like I'm I'm not using
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any blue to make blue
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um exactly I think he used like a teeny tiny
16:02
tiny bit of blue at the very
16:04
end is just kind of like accenting
16:06
but like the majority of the color
16:08
um I think you mentioned the like the color science
16:10
behind it
16:11
was that you don't actually need blue to make blue
16:15
I think that he needed
16:16
like green and yellow and a little bit of Hazel
16:18
you know like just some brown in there and
16:20
and gray a lot of gray and
16:22
like it was it was super interesting to me um so
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like usually this process
16:27
I think kind of from what I've heard it takes
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roughly three appointments
16:31
um why is this not just like like take a mold
16:34
and then just make the eye like what goes into
16:38
making it really feel like that's their eye right um
16:43
um I would say because we are not
16:46
simply just making an eye we are making an eye for
16:49
that individual person
16:52
the prosthesis has to work with the anatomy
16:55
with that individual socket so um
16:59
it's just not as simple as um
17:02
maybe some people look at it
17:05
human irises are incredibly complex they have layers
17:09
patterns subtle variation colors
17:11
lighter and darker areas
17:13
and variation around the pupil also so even the white
17:18
even the white part of the eye the sclera has
17:21
so much um tone depth and vascular details
17:26
during the different appointments I evaluate and refine
17:30
the shape the Fit Comfort eyelid support Iris
17:35
uh Iris size gaze
17:37
and also symmetry so these are all very
17:40
important uh and it we we we
17:43
we really want the patient to be patient
17:46
about this process because as patient as they are and
17:51
we we feel like more comfortable like
17:54
doing our best to put even more details to um
17:58
exactly try to exactly match their um um their good eye
18:04
yeah absolutely um it's it's definitely like
18:10
I think it's just a it's just a really
18:13
like you don't really know what you're gonna feel I think as the patient
18:16
until you're actually like in it
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um and I think I was surprised um by
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a lot of the factors of like how my eye was made um
18:24
and I think one of the things was like
18:27
some of the things that kind of went into making my eye
18:29
look natural and
18:30
and I like I guess I want to give a little bit of a disclosure here because I know that there are
18:34
plenty of people in our community who have chosen to um
18:39
start the enucleation process
18:40
like from the get go and you might be someone who like you opted
18:43
for um
18:45
what did you call them Sara a party
18:47
eye is that what you called it or a party
18:49
eye a party eye like so yeah
18:51
there's there's some patients
18:52
there's as you know especially kids like if um
18:55
they've ended up having to have enucleation
18:56
sometimes
18:57
like they just want something a little more fun and like with some pizzazz
19:00
and that you know is
19:02
is how they're able to kind of take ownership and um
19:05
but I know for me like I
19:07
spent a couple of years with radiation
19:09
damage and then I was gonna get a prosthesis
19:11
and I was like I just want it to look as natural as possible
19:14
um so how do you like reassure patients
19:17
who come to you and are you know hoping that like okay
19:19
how can like this is a this is a a faux
19:22
eye this is a prosthesis like how can we actually
19:26
make it look natural like what goes into um
19:29
what goes into making them feel
19:31
confident I guess in that in that part of the process
19:34
so um the most
19:36
important thing to me is I always want to listen
19:39
I want to listen and understand
19:43
um to to to know about what the patient actually wants
19:48
you know out of to get out of the prosthetic eye
19:51
uh sometimes as you said they just want
19:54
perfectly matching
19:56
you know natural looking um prosthetic eye
19:59
I had so many patients several patients they they
20:03
they didn't
20:03
even want to have a natural eye they wanted to have
20:06
like as I said
20:07
Party Eye or some people they call it fun eye
20:10
um this is something personal
20:13
and this is something that
20:14
we have to listen and understand
20:17
why the patient wants that and try to address
20:20
that try to help them to go through that process um
20:24
I had also have patient that um wanted to have
20:28
first wanted to have the natural eye and then
20:31
also to have a party eye
20:32
which I don't recommend to switching between eyes it's
20:35
just you know it's not good for your socket but um
20:39
this is something that you should listen for sure and
20:42
see what's the story
20:44
behind it and why do they feel comfortable
20:46
or confident about getting something that may
20:49
feel personal to them it is very important
20:52
you've seen a lot of patients
20:53
in the time that you've been practicing
20:55
and I feel like it's gotta be a pretty powerful moment
20:57
when someone sees their prosthesis for the first time
21:00
especially from your perspective after having
21:02
kind of been through this journey with them
21:04
whether it's been just those three days or like you know
21:06
longer time but what do you typically
21:09
see in that moment when patients are kind of like
21:11
I guess locked into like this is my eye
21:14
and I get to I get to leave the office with this
21:17
um that actually Danet can be um
21:20
one of the most meaningful um
21:23
part of um my work um but there is no one correct um
21:29
reaction some people smile immediately some people cry
21:34
some people uh become very quiet some
21:38
wants to study themselves
21:39
in the mirror for a long time and occasionally
21:42
the reaction is
21:43
much more reserved than their family or even the ocularist
21:47
expect I think it is very
21:49
important to not to put pressure on patient
21:51
to have the dramatic reaction
21:54
for us we may be seeing a completion of the prosthesis
21:58
but for the patient that moment
22:01
may represent everything they have been through
22:04
the diagnosis surgeries uh
22:07
all the cancer treatment pain fear and
22:11
at the end the loss so there can be many many
22:15
emotions happening at the same time
22:17
I think ocularist have to be
22:20
um comfortable allowing the silence
22:24
sometimes the most respectful thing I can do is simply
22:27
let the patient just look um
22:31
they don't always need to um
22:33
they don't always need me to immediately ask
22:36
do you love it how do you feel about it
22:38
that moments belong to them
22:41
for one patient it may be immediate relief
22:44
I I've seen that
22:46
so many times for someone else it may take time
22:49
for their brain to adjust
22:51
um to seeing their face differently again
22:54
they may love the processes technically
22:57
while still feeling emotional about everything
23:00
that they led them to get one of those
23:03
physical rehabilitation and emotional adjustment
23:06
do not always happen at the same time
23:09
oh man yes it's definitely
23:11
such a such a good thing to remember that like
23:14
I mean I
23:15
I just love what you said about like really this is about the patient
23:18
right like and and you as the ocularist
23:20
have Learned to just sit in that silence
23:23
like and just to I I can imagine like
23:25
I don't know like as an artist
23:27
that it would be nice right it would be nice to like have some validation
23:29
of like oh like I love it like it looks so good but
23:33
it's not about you it's about the patient
23:35
and I love that you put that emphasis in
23:37
you know the way that you practice
23:39
and the way that you sit with your patients
23:41
during and and also like after the process um
23:45
how long do you feel like you have seen patients
23:48
kind of like as they're adjusting
23:50
to having their prosthesis
23:52
obviously you know they leave
23:53
they leave your office and I'm assuming
23:54
they come back periodically
23:56
for like adjustments or for um
23:59
like cleanings perhaps but
24:01
you know that first reaction
24:03
is that typically when someone feels
24:05
like whole or do you feel like
24:06
sometimes it takes a little bit longer for for people
24:10
um I would say in my experience um um
24:14
the first time getting their prosthetic is the most um
24:19
hmm
24:20
it's the most time that I've seen them
24:23
their reaction that they're just
24:26
you could see hope in their eyes
24:29
again you can see that when they're um
24:31
looking in the mirror after delivering a prosthesis
24:34
um you can see something shift emotionally
24:39
um in my experience the delivery day is um
24:43
one of the most moments that I have seen that
24:46
but they had been patient
24:47
I have been working with that they needed more time
24:50
to adjust their brain and adjust themselves and um
24:54
like um for example after they
24:56
came for the follow up um
24:58
appointment which they're
25:00
very important follow up appointments or
25:02
even for polishing I could see a very different
25:06
person different you know like whatever
25:09
they're talking about how much they are happier uh
25:12
rather than the day that I deliver
25:14
that processes so it depends
25:16
to different people it's very varies
25:20
yeah absolutely um I I guess I kind of feel like
25:24
just thinking about my experience like that it's
25:27
like I felt like my eye felt like mine by the end of
25:31
like the delivery appointment
25:32
right like that last appointment when I walked
25:34
away like it felt like it belonged to me
25:37
but I think it still took some adjusting
25:39
like to like what do I do like basically
25:42
how do like how do I accommodate this in my life right like that was
25:45
that was definitely how are other people gonna
25:47
react to you like how are other people gonna react
25:50
which is so funny because like I mean I have sisters
25:52
who like you would think it's been like four years
25:55
coming up on five since I like have had
25:59
actually not quite four years but
26:01
but it's been like four years since my eye was enucleated
26:03
and I've had a prosthesis since
26:05
January of 2023 maybe February
26:08
like you would think that everybody
26:09
would know which eye is is the prosthetic
26:11
by now but like no like people still mix it up like and so
26:15
that's you know in some ways
26:16
kind of gratifying for me like to be like okay like
26:19
well it's obviously not obviously different
26:21
like you know in a way that I feel like it might be
26:24
so that's always reassuring um anyway yeah so I digress
26:28
um one of the things that we chatted about was this
26:30
idea of like you know gratitude for obviously
26:33
with a cancer diagnosis like grateful to be alive
26:35
but also like grieving
26:37
the fact that like you know you did lose an eye um
26:39
how do you see those two
26:41
emotions like showing up in your patients
26:43
I see those two emotion coexist very often
26:49
especially with patient who have survived cancer
26:52
or any other serious illness people
26:55
around them naturally wants to celebrate
26:58
the cancer is gone you made it
27:00
you're alive those things are incredibly important
27:03
but the patient may still look in the mirror
27:06
and miss their eyes
27:09
they they may still miss their face after surgery
27:13
they may still feel uncomfortable
27:15
when people looking at them
27:17
they may still be grieving
27:19
gratitude does not erase grief
27:22
and grief does not mean someone is ungrateful
27:27
um sometimes I think patient
27:28
actually need permission to acknowledge their loss
27:32
there can be pressure
27:33
to move very quickly into positivity
27:36
but sometimes healing begins by simply recognizing yes
27:41
this is this was hard yes
27:43
something important was lost
27:46
we don't always have to immediately
27:48
turn a painful emotion into an inspirational one
27:53
and I think it might be
27:55
someone who is genuinely grateful
27:58
that their cancer treatment was successful
28:01
but still avoids looking in the mirror
28:04
it might be someone who is excited about
28:07
their prosthesis but also cries
28:09
when talking about their surgery at one
28:12
what they had been through
28:14
so all those emotion can sit besides each other
28:18
yeah absolutely
28:19
um I think that's one of the things that I've had to
28:21
learn a lot as a cancer patient is that
28:24
you can have and hold two emotions
28:26
and they can be completely opposites of each other
28:30
um and that can feel
28:31
pretty uncomfortable I think sometimes but
28:33
um I do think that it's important
28:35
like to to just recognize that they can coexist um
28:39
okay let's chat like a little bit more about
28:42
life right life after you've lost an eye
28:44
um there's definitely that kind of Assumption
28:46
right that like your life is gonna be smaller
28:49
or somehow like less because you don't have an eye
28:52
um so what do you wish that people who are facing
28:56
enucleation
28:57
could just know about like what their life can still look like in the future
29:19
so the thing I want people to hear is your life
29:23
does not end at your eyelash
29:27
there will be adjustment for sure absolutely
29:30
losing vision in one eye
29:32
um can affect so many things such as depth
29:35
uh uh depth perception
29:37
peripheral visual field and everyone has a different
29:41
medical situation but I meet people who return to work
29:45
raise families travel exercise enjoy hobbies
29:50
spend time with friends and continue living
29:53
um a very um
29:55
continue living very full lives
29:58
at the beginning people focus uh usually they focus
30:02
everything they think they are going to lose
30:05
but over time I promise
30:08
over time they begin discovering
30:11
everything that is still possible for them to do
30:15
okay so Sara I want to do a little bit of a
30:18
I don't know like let's just dispel some of the myths
30:21
around having a prosthesis and
30:22
and you know you mentioned
30:23
that people really can live
30:25
pretty normal lives and just
30:26
continue doing the things that they enjoy
30:28
those hobbies but let's get specific so um
30:31
swimming can I go swimming with the prosthetic eye
30:34
for sure okay what about sports
30:36
like specifically maybe contact sports
30:39
no you can um definitely do any sports you need to do
30:44
okay you mention travel like flying boats
30:47
everything fine everything is fine
30:49
you can just live as normally
30:51
as someone has with two eyes
30:53
it is very important to protect your good eye
30:56
and at the same time um
30:58
you're protecting you know both parts
31:01
um when you're doing like a
31:03
maybe some more aggressive um yeah sports or
31:08
activities don't go too crazy
31:09
right like let's not go too crazy don't go too crazy
31:12
yeah um okay so makeup like is makeup
31:16
still fine to wear like for anyone who wears makeup
31:19
I I absolutely recommend
31:21
having makeups because it makes it
31:23
even much more natural
31:26
okay what about MRI
31:28
I feel like it's always on the MRI question
31:30
of like do you have a prosthetic limb
31:32
or like do you have a prosthetic eye
31:34
and like I always say like
31:35
like yes I have a prosthetic eye
31:36
but like is it MRI safe and like
31:39
so if you have an acrylic
31:41
uh an acrylic prosthesis is that one MRI safe
31:44
yes it is safe okay um what about polishing
31:48
like I know some people like
31:50
like cleaning at home versus
31:52
polishing with your ocularist
31:53
like how often should your
31:55
should your prosthesis be polished
31:57
so as far as polishing
31:58
I do not recommend anyone doing it at home
32:01
and I really appreciate that um I do recommend
32:05
coming for polishing
32:07
at least once a year
32:09
some people I have some patient they come
32:11
every six months because it all depends on different
32:14
uh sockets uh sockets and um you know how much uh
32:19
their socket gets more goopy
32:21
or you know they need more uh polishing um
32:24
so it all depends
32:25
on different patient but I do recommend at least uh
32:29
having it once a year polish yeah for sure um
32:33
so what about cleaning
32:34
like I mean do you recommend that your
32:36
um that your patients just basically leave their eye
32:39
alone like they don't take it out when they go to sleep
32:41
like just basically leave it in
32:42
um or do you recommend like periodically
32:44
just kind of cleaning it off at home
32:46
so um I recommend um
32:49
not to take it out at all unless it's necessary
32:52
like emergency happens
32:54
uh you can get eyelashes behind it
32:57
that there's no way you can get rid of it so
32:59
in those cases um
33:01
that's why we always go through how to um
33:04
put the eye in in the socket
33:06
how to take it out because I wanna make sure they know how to do it
33:09
just in case if they need but
33:11
they don't need to take it out at all
33:13
but I do recommend cleaning it um
33:16
twice a day morning uh when they um after they wake up
33:21
uh evening before they go to bed without taking it out
33:24
my recommendation is to use saline
33:27
solution which is for soft contact lenses twice a day
33:31
morning and evening um
33:32
when they after they wake up before they go to bed
33:35
um they can just simply uh flush it with the uh
33:38
saline or they can use a small eye cup hold it right uh
33:42
to their eyelid and then just give it a wash
33:45
that's all they need to do they can also hold a towel
33:48
you know to avoid making a mess but this is all
33:52
they need to do they don't need to take it out at all
33:54
and then um until they come back uh to me uh
33:58
to have it polished yeah absolutely
34:01
okay so then last question here before we move on
34:03
um how often do you recommend having a replacement
34:08
so again this different between
34:10
different people and patients I have um
34:13
it depends uh if sometimes the socket start changing
34:17
sometimes they are having more surgeries
34:20
so in those cases
34:21
we we have to evaluate and uh go with the flow
34:25
but if um nothing is changing uh we usually recommend
34:29
uh getting a new prosthetic between um like
34:32
maximum five years is good um um
34:36
some some patient they can go further than that um
34:39
some I had patients coming after three years um
34:42
the the whole socket had changed and um their eye
34:46
you know it just it was just not fitting
34:48
right anymore and they needed a new shape
34:51
but usually if the everything
34:53
is going well we can do with some little adjustment
34:57
either enlargement or reduction
34:59
we can adjust the processes to
35:02
still be good for that patient
35:05
yeah absolutely okay
35:08
um let's get into the last couple of questions
35:10
that I have for you before we wrap
35:12
um Sara this has been so fun
35:14
thank you for chatting with me and
35:16
of course sharing your expertise and your um
35:19
your wisdom here I think it's really helpful my
35:20
pleasure um
35:21
and I hope you guys listening
35:22
that like you guys are like taking
35:24
nuggets from this because I feel like it's just really
35:26
um
35:27
it's really helpful I think to hear from different people about like kind of the process
35:30
alright so Sarah you mentioned that patients
35:32
remember how they feel um sitting in your chair
35:36
not just like the prosthetic that you made for them um
35:39
what do you think helps someone
35:41
feel genuinely cared for during this kind of process
35:44
um
35:45
technical skills I would say technical skills matters
35:48
enormously the prosthesis has to be has to be made well
35:52
but patient doesn't experience care only through the
35:56
final prosthesis
35:57
they experience the room that they're sitting in that
36:00
they remember whether somebody listened to them
36:03
they remember whether they felt rushed
36:06
they remember whether they felt comfortable asking
36:09
so many questions they
36:11
remember whether they felt like a person or just an
36:14
another appointment
36:16
my father taught me how to create prosthesis
36:19
but one of the most important
36:22
lessons I Learned from him
36:24
was that there is a human being
36:26
attached to that prosthesis to every single case
36:30
it had to have been such a privilege
36:32
to learn from your dad um
36:34
and to learn you know to be able to be in this field um
36:38
I just think I mean it
36:39
it just is a huge testament to the
36:42
kind of ocularist and um anaplastologist that you are
36:45
um I just I feel like
36:46
I haven't even like met you in person and I feel like I would be comfortable
36:50
sitting in your office
36:51
if you know I moved to Colorado and said OK I guess I need a new ocularist
36:54
here that would be my pleasure
36:57
I know absolutely right anybody in Colorado
37:00
hit her up she
37:01
will put um will put her info for where you're at um
37:04
and like your practice and everything
37:06
in the show notes for people um thank you okay
37:09
well let's cover like that kind of I guess the fear
37:12
right because I think that overall
37:14
that's one of the biggest things that patients
37:16
experience
37:17
when they're told they're gonna lose an eye and they're just really scared
37:20
not obviously
37:20
just you know with the surgery but about like
37:22
who are they going to be afterwards um
37:25
what do you want to say directly to somebody
37:27
who's in that spot
37:28
the first thing I would say is you do not have to figure out
37:32
your entire future today
37:35
right now you may be thinking about everything at once
37:38
what will I look like will people notice
37:42
will I ever feel comfortable looking in the mirror
37:44
again will my family see me differently
37:47
will I still be me those fears are real
39:35
so Sara I'm not gonna take my eye out
39:37
even though I know you've you talked about like how it can be you know
39:41
most people should know if they've seen an ocularist
39:44
how to take their eye out but to save everybody
39:46
from like you know
39:47
me taking my eye out on screen um can you show us what
39:50
a prosthetic looks like absolutely um so here
39:55
if you can see it yeah I can see it
39:59
this is a prosthetic eye
40:01
for a special individual a socket
40:08
okay so it's it's just so
40:09
interesting to me like they're different shapes
40:11
like mine is definitely more triangular
40:13
in like certain ways oh yeah they're all different
37:51
but there are people who will help you
37:54
through the different parts of this process
37:57
your surgeon has one role your medical or oncology
38:01
team uh have another your ocularist has another
38:05
and also emotional support matters too
38:09
there is rehabilitation after eye loss
38:13
and there are very realistic prosthetic options
38:17
will everything be exactly the same as before
38:20
no I would never promise someone that
38:23
but I wanna say different does not
38:26
mean that your life is over
38:29
when someone
38:30
is newly diagnosed they often try to mentally
38:33
live the next five years in one day
38:36
they imagine every future birthday photograph workplace
38:41
interaction relationship and social situation
38:44
all at once that is overwhelming sometimes the most
38:49
compassionate thing we can tell
38:51
someone is you only need to
38:53
take care of one thing at a time
38:56
there will be time to deal with the steps after that
38:59
I love this um honestly I feel like for anybody
39:02
who's listening if you're in that spot
39:04
right where you're going into surgery
39:05
you're expecting you're gonna need a prosthetic eye
39:08
I hope that you can take something from this episode and from what Sara just shared
39:11
um just around this
39:12
idea that you know like you said you don't have to have it all figured out today
39:15
it's really okay to take it one day at a time and um
39:17
not do what I I would argue maybe
39:20
anxiety tries to do right like jumping
39:22
five years into the future
39:24
that's definitely what my mind
39:25
tends to go to as well so um
39:27
I appreciate like there's just the
39:29
the way that you're able to relate to patients Sara
39:31
and I hope that those of you guys listening
39:33
that you have found this super valuable um so
40:16
Sara about that I wanted to say thanks um
40:19
thanks for joining us on the Eye Believe Podcast
40:21
and we are so glad to have you so much
40:23
we're so glad that we can have you here yeah absolutely
40:26
um and like I said we'll put Sara's um website
40:30
and just like information
40:31
where you can like you know get in touch with her directly
40:33
if you're in the Colorado
40:34
area or in the nearby surrounding areas um
40:37
just because obviously
40:39
she has a very well established practice
40:41
and if you haven't heard of her then now you have and so maybe she's closer to you
40:45
especially if you're in one of those
40:46
kind of areas or or surrounding regions
40:49
but with that Sara I'm gonna let you go and
40:52
say goodbye to our guest
40:53
so thank you guys for listening
40:54
for subscribing and we will see you next time