LAUSR

ilamenPigmented filamentous lesions were seen on the underside of an ocular prosthesis being worn by a child with post-enucleation anophthalmic socket. Culture and staining revealed it to be Aspergillus flavus. This unexpected detection of fungus in a prosthetic eye makes us wonder what all may lie on the blind side of the prosthesis. Prosthesis use in ophthalmology may be secondary to an anophthalmic socket following enucleation or evisceration. The prosthesis can be prefabricated (stock shell) or custom fit. The most frequent complaint of the patients using eye prosthesis is discharge. These complaints are more commonly seen in patients using a stock shell than a custom fit prosthesis, the reason being a more snug fit of a custom fit prosthesis and obliteration of the dead space which causes pooling of secretions. A five-year-old healthy child from a lower socioeconomic stratum, presented to us for a custom fit prosthesis. Her right eye had been enucleated, with a non-porous implant, three years back for a disorganized globe. Following surgery the child was doing well with no history of socket infection. She had been wearing a stock shell for the past three years. The mother complained of occasional discharge for which topical antibiotic drops were instilled off and on. The mother was removing the prosthesis occasionally (once in two months), and reinserting it after cleaning with warm water. No antibiotic drops were being used at the time of examination. On examining the stock shell after removal, pigmented filaments were seen on the underside (Fig. 1). The socket examination was unremarkable. Lacrimal syringing was patent. Staining and culture of the filaments revealed it to be Aspergillus flavus (Figs. 2 and 3). The conjunctiva culture was negative for fungal and bacterial growth. There was no evidence of systemic mycosis. Comment