Raynaud's syndrome in nose

**Goldensummer** · 03-04-2015, 08:18 PM

I had a patient approach me with a question that I was not able to answer so I turn to you guys! We're located in the greater Boston area. My patient has Raynaud's syndrome in her hands and feet but also down the sides and tip of her nose. The syndrome causes her to loose blood flow and experience cold and numbness. She finds wearing glasses exacerbates the issue. She has tried silhouettes and even that pressure was too much. Can anyone think of a bridge modification that would work for her to either pull the pressure up higher or onto her cheeks? I was able to find some suggestions for post rhinoplasty but all of those options seem temporary. Any suggestions would help. I'd love to be able to send her to someone in the area who thinks they'd be able to do something.

Thanks in advance.

**Craig** · 03-05-2015, 08:40 AM

Build her a saddle bridge drill mount with lenses that sit on her cheeks. It will get greasy but it will do what you want.
We do this for those who have had skin cancer on the nose and we want to keep all off the skin where it was effected. The
Lindberg saddle is the thinest and lightest option.

**CCGREEN** · 03-05-2015, 09:25 AM

Back in my other life of yester year when I first started in this. We had a pt who lost her nose from cancer. I do not remember where we got it from because it was so long ago. But we found a plastic frame that fit like a head band and the frame front was suspended from the head band in front of her eyes. To compound the issue the poor lady was aphakic.
I dare say if you found someone handy soldering they could take any metal head band and any metal frame front, remove the pad arms and make what your looking for. I am sure it would cost very little. Doing it that way would keep lenses off her cheeks. But if she cant take the pressure of a headband.............umm lost for suggestions now. Contacts?

**SharonB** · 03-05-2015, 11:18 AM

I also remember "back in the day" keeping a stock of suspension eyewear that did not touch the nose at all. They were kind of like a plastic horizontal head band, with the snap-in lenses suspended from the top. We stocked them because a nearby plastic surgeon sent in his rhinoplasty patients for them to wear until the nose was healed.I think we got them from the now closed Franel... but I can't remember who made them. Maybe a google search for suspension eyewwar?

**Judy Canty** · 03-05-2015, 11:46 AM

Would this work?

http://www.hilco.com/Optometry/Detai...ctFamilyID=987

**eryn** · 03-05-2015, 12:51 PM

I don't believe these are available any longer but I think someone here on the board made a custom pair like it. Maybe Coupe?
It ain't pretty but...

**nicksims** · 03-05-2015, 01:16 PM

"Coupe" did start a thread on 2/20/15. Maybe there is a detail there that can help?

**SharonB** · 03-05-2015, 05:37 PM

Originally Posted by eryn

I don't believe these are available any longer but I think someone here on the board made a custom pair like it. Maybe Coupe?
It ain't pretty but...

Ahhh - That's what I was describing! We went through 40-50 a year back in the 70s & early 80s! Good find!

**CCGREEN** · 03-05-2015, 05:45 PM

Originally Posted by SharonB

Ahhh - That's what I was describing! We went through 40-50 a year back in the 70s & early 80s! Good find!

LOL Brings on the Flashbacks doesn't it Sharon. That's the exact one I was talking about. Color and all. I can still see that poor little ladys face void of a septum as I put these on her with her Aphakic lenticular lenses.

**walleye** · 03-05-2015, 07:57 PM

As a side issue for your patient concerning her feet. Tell her to buy Mag-Steps by Nikken. (May even find on ebay) They are magnetic inserts with "nubs" on them to put in your shoes and prevent the numbness in the feet. I use them all day during the winter here in the northeast. I can't be without them even at home in my bedroom slippers!!