Rimless Ptosis Crutch

[optical24/7]

Very sweet 89 years young patient has had several blepharoplasty surgeries over the years. The last one didn't hold for long. She can no longer safely be put under anesthesia. 1 year ago I applied a Ptosis Crutch to her current frame, but it turns out it's too heavy to stay up without extreme discomfort (due to how tight of adjustment was needed.)

I've never seen or heard of one, but thinking outside the box, I decided to apply a crutch to a Silhouette rimless, right into the lenses (Trivex). I took these pics this morning prior to pick up by the patient. Success! They are working great and she says they are so much more comfortable than her old pair. I tried to get her to let me take her picture to share, but she doesn't want to be an "internet model". Lord love her....

[PartTimer]

Little low rez for my tired eyes, how exactly did you mount them? Is this the "bent paperclip" method with shrink wrap or a temple tip? Kudos on the creative success.

[rbaker]

Back in the day before 1970 most optical findings were manufactured in Southeast Massachusetts and sold directly or through companies like Hilco or Sadler. Most journeyman Opticians had a few feet of gold filled wire at the bench for just such a task.

Alas, we have been reduced to freaking paper clips.

[tmorse]

Very sweet 89 years young patient has had several blepharoplasty surgeries over the years. The last one didn't hold for long. She can no longer safely be put under anesthesia. 1 year ago I applied a Ptosis Crutch to her current frame, but it turns out it's too heavy to stay up without extreme discomfort (due to how tight of adjustment was needed.)

I've never seen or heard of one, but thinking outside the box, I decided to apply a crutch to a Silhouette rimless, right into the lenses (Trivex). I took these pics this morning prior to pick up by the patient. Success! They are working great and she says they are so much more comfortable than her old pair. I tried to get her to let me take her picture to share, but she doesn't want to be an "internet model". Lord love her....

Good thinking outside the box!

[PartTimer]

Back in the day before 1970 most optical finding were manufactured in Southeast Massachusetts and sold directly or through companies like Hilco or Sadler. Most journeyman Opticians had a few feet of gold filled wire at the bench for just such a task.

Alas, we have been reduced to freaking paper clips.

No need to worry. VCPs and consolidation have taken care of that problem by reducing the amount of money you can make and destroying the incentive to learn, so we only attract salespeople and those who don't know any better. Takes care of itself.

[Chris Ryser]

Crutches are used to keep an eyelid from drooping due to Ptosis.

Individuals with Ptosis who are not candidates for reparable surgery or are looking for an alternative treatment, may consider Ptosis crutches.

A Ptosis crutch is bar that is placed along the inside of an eyewire frame that supports the drooping eyelid. The crutch is positioned where the orbital fold would typically be without Ptosis. The crutch should create a fold above the eye, tucking the lid in and raising it above the pupil.

The Ptosis crutch is designed around the shape and contour of the eye. It is typically made out of metal wire. To create the crutch, measurements must be first taken to determine the depth of the Ptosis eye crutch.

An optician may use a distometer or a millimeter ruler to take measurements. The distometer is held against the ocular side of the frame, at the middle of the upper eyewire. Measurements are then taken from the deepest point under the eyelid, up to where it meets the overhang of the eyewear's eyewire. Most measurements come in between 15 and 20 millimeters, but extended or reduced lengths may occur too.

It is important that the eyewear is properly adjusted to the back of the ears. Sometimes cable temples are recommendable for optimal functionality.

Ptosis crutches are a little-known option and are an alternative to surgery or eyelids that may not be currently repairable. Many optometrists may be unaware of it or may not know how to install the crutch on an existing pair of eyeglasses. A number of eyeglass companies can install Ptosis crutches to new or existing frames.

source:
https://en.wikipedia.org/wiki/Ptosis_crutches

[optical24/7]

Little low rez for my tired eyes, how exactly did you mount them? Is this the "bent paperclip" method with shrink wrap or a temple tip? Kudos on the creative success.

Sorry for the lousy pics, been here for years and still haven't figured out how to make them show up here like Steve does with his astronomy pics. I used a disco frames temple eyewire. It already had one crimp at the end to keep the temple cover on. I put another next to it 90 degrees opposite to make a + shape on the wire end that I would insert into the lens. ( If left round, the crutch could turn in the lens ) .

Drilled a couple of practice holes on a dummy lens to get the diameter right and placed the hole above the bridge. I put some UV glue in the hole and on the end of the crutch and tapped it in with an optician hammer. ( One of those dinky ones that aren't normally good for anything, but a lot of us have one laying in a drawer. :)

I had pre-bent the crutch for the distance I needed, taken off the trial frame. I only had brown temple covers on hand ( plan to switch out for clear when I source some) I used to cover the crutch with.

My main concern starting this project was twisting of the crutch in the hole I inserted it in. The + crimp along with a tight fit made the crutch very secure, enough so for manipulation and bending for a proper fit. It was a fun project to do!

[Hayde]

I'm really impressed, George. Well done. Your patient is lucky to have you in her corner.

[mervinek]

WoW! LOVE this! Really great job! Your patient is lucky to have you!

[Lelarep]

This is the stuff the public needs to see, this is why you go to a professional, and not a website.

[Tallboy]

You are a heck of an optician.

[Chris Ryser]

Looks good in theory ..............................

However I doubt that it works in practice. The ptosis crutch does need a certain distance from the eye............eyelid................eyelashes.

It also needs the optical centers in the correct place, due to optical reasons, we all should know about.

At the following link there are dozens of ideas to be found and you can make up your own mind:

https://www.google.ca/search?q=ptosi...mtnqatR0MlWXkM:

[Hayde]

Looks good in theory ..............................

However I doubt that it works in practice. The ptosis crutch does need a certain distance from the eye............eyelid................eyelashes.

It also needs the optical centers in the correct place, due to optical reasons, we all should know about.

At the following link there are dozens of ideas to be found and you can make up your own mind:

https://www.google.ca/search?q=ptosi...mtnqatR0MlWXkM:

There's plenty of distance from the lens here. (#3) With the wide variances of facial morphologies, how did you arrive at a conclusion of "probable" failure here--after a successful reaction at dispense?

[optical24/7]

Thanks for the kind words everybody.

Chris is right in that you just don't put a crutch on and hope it works. As mentioned earlier, you measure depth. Using a distometer to measure from the trial frame's lenses to the upper orbital margin for this patient was 18mm. I subtracted 1mm to account for lens thickness (since the crutch went into the lens.) The crutch is set 17mm behind the lenses. I also used a marker for vertical placement of the hole. Once fabricated, it need some slight manipulation to follow the contour of the eye.

So far so good. But if I ever do another (or have to re-do this one) I'll flatten the wire end going into the lens and cut a slot instead of a hole. It's secure for now, time will tell..