Dry Eyes / Shrinking Eye / Prosthesis / Complex Situation

Hi,
I have a question relating to dry eyes, but before I ask, I need to give some background information because it is a bit complicated.

OK, right eye was damaged 3 years ago, a piece of metal hit the retina (macular damage), today I have a scar on my retina and a shrunken eye with no lens and oil inside the eye.

I currently wear a prosthesis over my eye, and been wearing it for a year now, I take it out every night, most times I wear it for a long periods (example 10hours +). I use contact lens solution to lubricate the eye and notice sometimes its dry and red. Now this is where it gets interesting.

The other day I saw a dermatologist, and they prescribed a strong medicine called "Oratane" (also known as "Roaccutane") (Isotretinoin (INN) 20mg) to treat my acne. When I got home I did my research and found It's a retinoid, its similar to vitamin A but with a different action. It works by reducing the amount of oily substance produced by the oil making glands in the skin. A common side effect is "dry eyes".

Every time you blink, your eve gets lubricate. Because I wear a prosthesis the eye is usually dry, and now that I'm on Isotretinoin my eye is going to be even more dry.

My concern is that the eye will shrink even more, What is the long term effect for a dry eye?

Is there anything better than the standard refreshment tears that keep your eyes hydrated much longer, example an oil based drops?

Would the "Johnson's baby oil be safe to use as a moisturiser/lubricant (ingredients: Mineral Oil, Aloe Barbadensis Extract, Fragrance, Tocopheryl Acetate)?

I have notice, since I got my first prosthesis (a year ago) until now that my eye has changed, it is pointing in a different direction (cockeyed), probably because the prosthesis covers the eye which stops the light form entering the eye. And maybe have shrunken a bit more. What causes the eye to shrink?

In about 3 weeks I'm having a new prosthesis being made to correct the change in my eye. In the future can I expect my eye to continue to change?

[John C Hagan III, MD, FACS, FAAO]

I can't answer this question and I suspect there is no research on it since its such a limited application. You can ask your Derm, Ophthalmologist and the ocularist that made the prosthesis.

JCH MD