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JBSA News
NEWS | April 11, 2014

PROSE optical treatment helps save sight, allows patients to regain quality of life

By Maria Gallegos BAMC Public Affairs

Brooke Army Medical Center Optometry offers a special optical treatment for patients who suffer from severe complex corneal disease.

In collaboration with the Boston Foundation for Sight, an organization that has pioneered the device, BAMC's Prosthetic Replacement of Ocular Surface Ecosystem, or PROSE, clinic has helped hundreds of patients regain their quality of life, relieving chronic dry eyes, irritation, severe pain and blurry vision.

PROSE, which resembles an oversized contact lens, fits under the eyelid and creates a reservoir of fluid that continuously keeps the eye lubricated and protected.

The service was established in 2008 by Army Col. Jeff Cleland, U.S. Army Institute of Surgical Research ocular trauma officer in charge, and is currently under the direction of Army Lt. Col. Evelyn Reyes-Cabrera, BAMC Optometry Education Programs director and PROSE clinical fellow.

Cleland and Reyes-Cabrera are the only two military service members of the 15 trained PROSE clinical fellows in the world who are able to custom fit the PROSE device to the patient. Additionally, BAMC is one of only 12 BostonSight Network Clinics in the United States.

Reyes-Cabrera recalled the first time she saw the importance of the device and how it dramatically enables patients to regain their life.

"A few years ago, BAMC had an emergency come in," she said. "A wounded warrior was medically evacuated from Landstuhl, Germany and had sustained burn injuries to approximately 80 percent of his body.

"In order to save his eyes, we immediately fitted him with a PROSE device to protect and shield his eyes from further damage," Reyes-Cabrera said. "The treatment really made a difference. He still wears his PROSE device and is now a successful full-time comedian."

The device is not for everyone, however. After a referral from a health care provider, a thorough eye evaluation is performed to ensure it is the right diagnosis for the patient.

"For many, the PROSE device is the last stop. However, before we can custom fit the device, we evaluate all options," Reyes-Cabrera said.

Army retiree Lewis Otero-Aquino developed a graft-versus-host disease, or GVHD, which is a complication following allogeneic tissue transplant, shortly after his bone marrow transplant in 1998. His ocular surface was adversely affected causing severe sensitivity to light, chronic dry eyes and excessive eye pain.

After many years of failed attempts to relieve his symptoms, doctors from BAMC's oncology and optometry staff referred him to the PROSE clinic as a potential candidate.

"His eyes were constantly burning and irritated," said his wife, Carmen. "He tried on the device for one hour and for the first time in a long time, I saw a sign of relief on his face instantly."

"Many patients we see daily suffer from severe dry eye syndrome due to potential side effects of their medications or their condition," Reyes-Cabrera said. "The treatment offers instant relief to the patient because the device is filled with saline at the time of the application, creating a reservoir that continuously bathes the eye, keeping them lubricated."

"A transplant saved my life, but the PROSE lenses afforded me the opportunity to enjoy my life again," Lewis said.

Retired Army Col. Cheryl Carson recently had similar complications after her acoustic neuroma surgery in 1992.

Since her surgery, she suffers from lagophthalmos, the inability to close her left eyelid completely, leaving the eye irritated, dry and sensitive. After years of unsuccessful treatments - including a gold plate procedure in which weight is introduced to the eyelid helping it to close - she was referred to the PROSE clinic.

"During my follow-up visit with my optometry doctor, I told her the gold plate was not working and my eye was constantly dry and irritated. She referred me to the PROSE clinic.
"I've had this PROSE device for about a year now and I love it," Carson said. "The device keeps my eye lubricated and protected so I don't have to keep my eye moist all day and night or worry about losing the eye drop bottles. The PROSE treatment gave me relief I have not had for years."

"The main goal of the PROSE treatment is not just to improve patients' vision acuity, but to improve their quality of life so they can go back to work - go back to their life - shop for groceries, drive around, spend time with their kids and not be miserable or be in constant pain," Reyes-Cabrera added.

"The device is not just about seeing - it's about how it improves the quality of life for our patients."

For more information about the PROSE program, call 916-1717.