Ophthalmology & Optometry/Stone eye

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Question
Hi Mr Dovie. I am writing a story set in the Dark Ages in which I would like to have a character who wears a white stone in place of a missing eye. Would this be possible without causing infection? With apologies for being gory, if his original eye had perhaps been burned out with a hot poker would that mean he could wear the stone without risk of infection as the socket is just burnt skin?
Apologies for the oddness of this post!

Answer
Craig,
Cool question and I'll walk you through it.
The short answer is sure, why not.  :)

But there's going to be a few stipulations...

It would be best if the poker enucleates the eye / the entire eye 'ball' is gone.  This would leave some periorbital fat, muscle and nerve to be cauterized/seal, and hopefully some of the glands that produce tears / etc. One of the biggest glands that produces tears, the lacrimal gland, is most important - the tears actually have antibodies/etc in them.  
Here's a link to a diagram of where the gland is (if it matters)...

http://www.daviddarling.info/images/lacrimal_gland.gif

From a medical/scientific standpoint a foreign body in the eye is ok as long as it's inert and doesn't trigger the immune system. So the rock would need to be clean(ish), and very smooth - that's the key.  You may want to make this a river rock/etc that's been smoothed over time. Again, we'll want/need some kind of lubrication, so you may want to seed that in there - maybe something like: after he put in his new 'eye' he hit the floor in pain as tears rolled down his cheeks. after his head cleared, it dawned on him, that even the stone eye had been crying. that's good, he thought, it wasn't a total loss.  (haha, i'm NOT an author...can you tell?)
I hope this helps, let me know if there are any other questions!
Dr.D

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John M. Dovie, OD, FAAO

Expertise

As a residency-trained Fellow of the American Academy of Optometry I am able to answer most questions regarding eye and vision health. Anything is welcome, ranging from dry or allergy eyes, bifocal contact lenses, or thoughts on LASIK surgery. As I am not a surgeon, detail-oriented surgical-related questions may be better answered by an ophthalmologist.

Experience

Selected to participate in the PCO residency program in Philadelphia at The Eye Institute, where I worked OD and MD specialists gaining invaluable experience in various clinics including glaucoma, cornea and cataract, oculo-plastics, retinal disease, neuro-ophthalmic disease, primary care, emergency medicine, and special populations. Have practiced and trained in numerous settings including hospital, academic, retail and private practice. I earned my Fellowship in the American Academy of Optometry (FAAO). There are currently only about 3000 active fellows worldwide, and there are only about 70 Fellows in the state of Virginia. I currently own and operate my own optometric practice/clinic.

Organizations
American Academy of Optometry, American Optometric Association (Contact Lens/Cornea Section member since 2001), Southwest Virginia Optometric Association, Virginia Tech Alumni Association

Publications
Seminars/Presentations:
“Nyctalopia as the Presenting Sign of Vitamin A Deficiency: A Late Complication of Gastric Bypass Surgery.” Clinical Case Study Poster presented at The American Academy of Optometry Denver, Colorado, December 2006, co-authored with Bradley Lane, OD.
“The Importance of Considering Paranasal Sinus Mucocele as a Differential Diagnosis in Diplopia.” Clinical Case Study Poster presented at The American Academy of Optometry San Diego, California, December 2005, co-authored with Kelly Malloy, OD, FAAO and Cherie Farkash, OD.
“Acute Onset of Halos and Glare: Bilateral Keratitis—An Atypical Presentation of Amiodarone Keratopathy.” Clinical Case Study Poster presented at The American Academy of Optometry Tampa, Florida December 2004. Also Presented to New Jersey Academy of Optometry, Neptune, New Jersey March 2005.
“The Opportunity for an Optometrist to Save a Life.” Clinical Case Study and Grand Rounds Presentation presented at The Pennsylvania College of Optometry, Philadelphia, Pennsylvania, September 2004.
Publications:
“Corneal whorls cause wonder.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 10/15/2006.
“Acute onset of halos and glare: bilateral corneal epithelial edema with cystic eruptions--atypical presentation of amiodarone keratopathy.” Co-authored with Andrew Gurwood, OD, FAAO. Published February, 2006, Optometry.
“Pondering the posterior polka-dots.” Clinical Challenges Quiz, co-authored with Andrew Gurwood, OD, FAAO, Review of Optometry. Published 5/15/2005.
Professional Involvement:
“AION: Amiodarone-Induced or Anterior Ischemic Optic Neuropathy?” Participated as a peer-review referee for Expert Review of Ophthalmology (London, UK); refereed 10/2006.

Education/Credentials
Bachelor of Science, Cum Laude, Virginia Tech. Bachelor of Science, Pennsylvania College of Optometry. Doctorate (OD), Pennsylvania College of Optometry Residency, Pennsylvania College of Optometry Fellow of the American Academy of Optometry

Awards and Honors
Winner, First Place, "Best Beside Manner" by Our Health Magazine: 2012, 2013, 2014 Winner, First Place, "Best Eye Doctor" by The Roanoke Times: 2013, 2014 Recognized as a Fellow of the American Academy of Optometry, December, 2006 Recipient of the Onofrey G. Rybachok Memorial Scholarship, 2000-2001 Member: The Golden Key International Honor Society Member: The National Biological Honor Society Member: The National Honor Society Eagle Scout awarded 1994

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