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Orbital Implants & Orbital Floors

Discussion in 'Diving Medicine' started by Blindsided, Jan 11, 2018.

  1. Blindsided

    Blindsided Angel Fish

    # of Dives: 0 - 24
    Location: Punta Prima, Menorca
    20
    3
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    Where do I start this post? Scuba has always been on my to do list, but more as a chalk it up as something I'd love to do and certainly when I had two eyes, the romantic notion of becoming an underwater photographer.

    Money, fear and lots of things meant I never did it.

    Fast forward to losing an eye, a completely blown out orbital floor and having a growing list of replacement parts in this vessel, I've hit 40 and on a recent trip to Cuba, I finally 'took the plunge' and did scuba. It would be an understatement to say I'm hooked.

    That was November. A pool dive, 2 ocean dives and in December another pool dive and I've paid to do my PADI OW. I'm yet to book a physical course date (possibly the week after next). But having read through some of the forums, I'm frankly 'bricking it'.

    I'll obviously have to declare in my medical questionnaire that I have a titanium mesh orbital floor and an orbital implant in my sclera where once there used to be a cornea and vitreous fluid and all the other bits that make up an eye.

    After a VERY long post, I guess the crux is:

    1. Does anyone know if these in themselves prevent me from passing that part of the medical.

    2. My orbital implant is made up of a material that allows blood vessels etc to grow through it, in anyone's opinion is that likely to cause a problem to OW depths and could it possibly prevent me from doing AOW or DM (baring in mind that ridiculous romantic notion of underwater photographer)

    3. Am I more likely to suffer ill effects like sinus trauma etc based on the titanium I have going on in my socket

    And a number of other questions that my brain is still trying to compute.

    Thanks for reading (it's loooong) and in advance for any advice or sharing similar experiences.

    KP
     
  2. divesergeant

    divesergeant Solo Diver

    # of Dives: 500 - 999
    Location: Midwest USA
    495
    73
    28
    Hi Blindsided,

    Greetings from across the pond.

    I had questions about diving with the type of pain-in-the-butt contacts I have to wear to achieve good vision. After much research (which only gave me more questions) I called DAN. They gave me the answer I sought within minutes and put my mind to ease.

    They'll likely want to know the specifics about the types of implants you have as well as the underlying reason for the loss of the eye.

    I can't give you an answer to your question but hope maybe a call to DAN might.

    Best wishes,
    DS
     
    Blindsided likes this.
  3. Ricardo V.

    Ricardo V. ScubaBoard Supporter ScubaBoard Supporter

    # of Dives: 1,000 - 2,499
    Location: Palm City, FL
    312
    280
    63
    @Blindsided,
    Hope you find a clear answer to your questions. As mentioned by @divesergeant, you are better off asking DAN. They also have a directory of Doctors that understand the sport and will not just have a casual opinion, but one based on knowledge and understanding of what happens with our body at depth.

    I’ve got scleral buckles around each eye and am able to stay active and dive since these happen to be solid silicone and free of any internal gaps... in other words, the buckles won’t contract nor expand with changes in depth as there is no opportunity to trap air within interstitial spaces.

    I’m sure you will find a knowledgeable doctor that can answer your questions. I do find it interesting that you had a chance to dive and enjoyed the experience, so that in it self is proof it can be done.

    Any slight change in pressure will usually reflect in instant pain. I’m not a doctor, so don’t take all I’m saying as clearance for you to dive, but just an opinion.

    One last thing, don’t give up on the underwater photo dream. I’m challenged when it comes to overall eye health, but that does not keep me from diving, nor practicing underwater photography. It’s a fascinating hobby.

    Hope this helps,

    Cheers,

    Ricardo
     
    Blindsided likes this.
  4. Duke Dive Medicine

    Duke Dive Medicine Medical Moderator Staff Member

    1,891
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    Hi Blindsided,

    With the strong caveat that ocular and facial surgery are not my areas of expertise, I'd offer a couple of things.

    First, as you and Ricardo touched on, I would recommend that you check with your surgeon to ensure that there are no areas of potential gas trapping, not only in the surrounding sinuses but also the prosthesis and surgical area. I'd also look for the possibility of a one-way valve effect that would allow gas to travel one way but not another.

    Second, if you aren't diligent about equalizing the pressure in your mask on descent by exhaling through your nose, negative pressure can develop inside the mask which may have the potential to affect your implant and/or surgical area. To what degree, I'm not sure... it depends on the extent of the damage, the strength of the repair, the level of scarring, and probably other things I haven't thought of. You'll need to collaborate with your surgeon to consider this risk and whether he or she thinks it could affect the area.

    I don't believe your risk of decompression sickness in the area would be significantly increased, but this too would be worth exploring with your surgeon. If circulation to the area is compromised, it's theoretically possible that bubbles could form after decompression (again, I think this is unlikely but at least worth looking into).

    The London Diving Chamber is staffed by physicians with expertise in diving medicine. I would recommend that you reach out to them and see if they think you need to be seen by a diving medical professional. Here's a link: Decompression Illness Treatment, decompression sickness / DCS / decompression illness / DCI / diving and the bends, London Recompression & Hyperbaric facilities - The London Diving Chamber

    If you're medically cleared to dive, what's to stop you from becoming an underwater photographer?

    Best regards,
    DDM
     
    Ricardo V. and Blindsided like this.
  5. hammet

    hammet Barracuda

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    Had my orbit rebuilt and a prosthetic floor put in thirty something years ago. I got certifieda year or two later and never even thought twice about it. Obviously no problems diving. I don't put squat on those sheets.
     
    Blindsided likes this.
  6. Blindsided

    Blindsided Angel Fish

    # of Dives: 0 - 24
    Location: Punta Prima, Menorca
    20
    3
    3
    Thanks everyone for your replies. On my phone so scrolling back up to reply will be a pain! I'll respond to all when back in my laptop. And can read it properly too!
     

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