1. Test EOMs: prosthetic should move fairly well in comparison to the intact eye
2. Hirschberg test: to verify alignment of prosthesis
3. Remove the prosthesis: Check for hygiene! Patients must be advised to clean the device once a week or at least once a month. If a patient complains of itching behind the prosthesis, remove the device and check for bacterial conjunctivitis or GPC (often, the conjunctiva is left intact). Treat the patient according to standard protocols for either conjunctivitis or GPC. If treating with steroids, use of the prosthesis is to be discontinued for 1-2 weeks.
4. Lubricants: The conjunctiva and remaining tissues (if present) may be dry. Enuclene is a lubricant specifically made for prosthetic ocular devices and is recommended for this special population.
5. Wear and Tear of Prosthetic: check for cracks and accumulation of surface protein; these may irritate the conjunctiva.