Removing and replacing a special eye for cleaning and maintenance does not cause pain.
However, the physical action of manipulating the area can distress children. When children are anxious, they naturally tense up in anticipation of pain. The tension created can in itself cause pain where there would be none if the child were able to relax.
Depending on your child’s body, the eye may need daily cleaning. It is important for you to gain familiarity, confidence and comfort managing the removal and re-insertion of the eye.
Many parents are uncomfortable initially when faced with regularly managing removal of the special eye for cleaning.
When you are unsure or nervous about regular removal or maintenance of the special eye, your child will pick up on that and may show upset or fear when cleaning needs to be done.
Remember that the more you do something, the more comfortable you are doing it. With that comfort comes confidence. You can do this, and you and your child can be successful together.
Your Child’s Role
Many children over the age of 2.5 to 3 years have the fine motor skills to assist in appropriate care and removal of their special eye. They should be carefully prepared and supported in learning how to do this safely.
Many children like to be independent. Handling the special eye is a natural task they should learn so it can be a part of their everyday self care, like learning to button a shirt or tie a shoelace.
Practice and preparation are important parts of making friends with your special eye. So have your child make eye care a part of the daily routine, along with bathing and brushing teeth.
Several stuffed animals and puppets have been created to help children practice removing a special eye. They are very expensive with low availability, but your child’s ocularist or hospital may have one. However, they have limited scope. Allowing your child to gently explore and gain familiarity with the real special eye is essential.
Children need to learn to take out, clean and replace their special eye in case it is dislodged or needs to be cleaned when a parent is not present.
Knowing how to handle this independently makes this possibility manageable and reduces stress for everyone – the child, parent, teachers and peers.
The Handling Process
Knowing how to remove and replace the eye reduces stress for the child, parents and carers.
Reducing anxiety during the handling process enables the child to learn and be involved.
Go through the following steps together, one at a time, and repeat them regularly to develop confidence. Use the anxiety reducing approaches below to support yourself and your child through each stage of the process.
Wash hands (make sure fingernails are always trimmed/maintained)
Look in the mirror (this visual of the eye is important until children master the steps)
Gently touch the area around the special eye.
Place your pointer finger in the corner of the special eye, closest to the nose (children often like to use their dominant hand to do this).
Gently press inwards, and hold the special eye between the pointer finger and the thumb.
Gently slide the special eye out of the socket.
Carefully clean the eye with cotton/gauze pads and cool boiled water.
To return the special eye to the socket, gently lift the upper eyelid with the pointer finger of the non-dominant hand, sliding the special eye under the lid, closest to the nose again.
Push the special eye slightly upwards, while pulling down the lower eye lid with the thumb of your other hand, and slide the lower lid over the special eye.
Blink and adjust as needed.
Anxiety Reducing Activities for Children:
Some children become upset or fearful about having the special eye touched, removed or manipulated by parents or other people. If your child is anxious, it is important to practice anxiety reducing activities to help him calm down and get through the experience.
Some anxiety reducing activities children can learn, practice and implement when necessary are:
Deep breathing – imagine blowing up a balloon, or blowing away fear and discomfort
Counting – counting up to 10 or down from 10, counting how quickly it takes Mom or the medical team member to remove the special eye
Singing a song – singing a favourite silly song or calming song, or writing your own song that helps you relax.
Guided imagery – taking a trip in your imagination to a favorite place, or imagining that you’re a robot transformer changing shapes while your special eye is being removed.
Stress balls – squeezing a stress ball or shape can help you squish away all your fears and upsets. Hold the ball and squeeze for 10 seconds.
If a child is really upset and resistant to other members of the medical team touching their special eye, the best approach is to teach him how to do it independently.