BostonSight PROSE User manual

PROSE Device
Use and Care Guide
www.bostonsight.org
Start seeing the world again.
PROSE
®
®
by
Copyright 2022
No part of this document may be reproduced
or distributed without the consent of BostonSight
20220728 Device and Care Guide
BostonSight
464 Hillside Ave, Ste 205
Needham, MA 02494
781-726-7337

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TABLE OF CONTENTS
Contact Information.................................................................................................
SET UP and APPLICATION
Set Up: PROSE Device Application..............................................................
Preservative Free Saline Protocol.................................................................
Key Points for Optimal PROSE Device Application......................................
The Lid Spread is Everything........................................................................
How to Apply Your PROSE Device with a Plunger.......................................
How to Apply Your PROSE Device with a Lighted Plunger...........................
How to Apply Your PROSE Device with a Plunger Stand.............................
Bubbles Under Your PROSE Device.............................................................
REMOVAL
Set Up: PROSE Device Removal..................................................................
How to Remove Your PROSE Device with a Plunger...................................
How to Remove Your PROSE Device without a Plunger..............................
DISINFECTION and CARE
Set Up: Your PROSE Case...........................................................................
Set Up: PROSE Device Care and Cleaning.................................................
Nightly Disinfection Protocol for Your PROSE Device..................................
Morning Protocol for the Application of Your PROSE Device.......................
FAQ for Current BostonSight PROSE Patients.......................................................
PROSE Accessory and Solution Buying Guide.......................................................
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www.bostonsight.org
464 Hillside Avenue, Suite 205
Needham, MA 02494
CONTACT INFORMATION
Increased eye redness, pain, discharge, sensitivity to light, and/or significant reduction in vision may
signal infection and requires IMMEDIATE attention. Please contact your primary eye care provider and
ask them to keep your PROSE doctor aware of any findings.
Warning
Main Phone: [phone]
Main Fax: [phone]
Doctors and staff CANNOT respond to medical
issues via email.
PROSE device problems, including
application, removal, or cleaning
Patient Emergencies (BostonSight, Needham only)
(after hours, weekends, or holidays)
Please note the patient emergency line is for
BostonSight-Needham patients ONLY. If you are not
a BostonSight-Needham patient, please contact your
PROSE provider directly.
Order a replacement PROSE device(s) or for
damaged or lost devices, please contact:
Insurace Pre-Authorization
1. Review this guide
2. Visit www.bostonsight.org/patient-resources to view
our Device Application and Removal video series.
3. Call 781-726-7494 to leave a message for an
ophthalmic technician.
Patient Emergency Line: [phone]
The emergency telephone line should NOT be used in
cases of broken or lost devices, medication
questions, or solution and cleaning questions. Please call
our office during normal business hours to discuss any
non-emergency issues you may be having.
Device Coordinator: [phone]
If you are requesting device servicing, complete the
form linked below and include it with your devices.
https://www.bostonsight.org/patient-resources
Insurance claim follow-up/appeal
Loren Stead: [phone]
Lynn Carter: [phone]

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You will need a soft towel to be placed on top of a clean work surface where you will apply
your device(s).
You will need the following supplies:
• An application plunger
• A removal plunger
• A small mirror
• Preservative-free saline
Set Up: PROSE Device Application
Preservative-Free Saline Protocol
application
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PuriLens Plus Preservative Free Saline is a sterile saline solution buffered with
boric acid and sodium borate. It is not a standalone cleaner or disinfection
solution and it does not substitute for nightly cleaning and disinfection.
WARNING: PuriLens Plus Solution is not to be used with the PuriLens cleaning
chamber for PROSE. This chamber is to be used for other contact lenses, but
not PROSE devices. PuriLens Plus solution can be ordered directly from the
manufacturer at https://www.purilens.com or by calling [phone]. It is
also available at https:/www.amazon.com.
Sodium Chloride 0.9% vials for nebulization. This is unbuffered, preservative
free saline that comes in 3ml or 5ml vials. An example is the AddiPakSodium
Chloride 0.9% vials. You can request a prescription, however they may not be
covered because they are intended for nebulizers and are used off label. They
are also available for purchase without a prescription at
https://www.medonthego.com, https://www.amazon.com,
https://www.myeyesupply.com, or https://www.dryeyeshop.com.
ScleralFil by Bausch & Lomb is a sterile,buffered isotonic saline solution. Each
carton contains 30 10ml vials. It is available at
https://www.bauschsvp.com/lens-care or https://dryeyeshop.com.
LacriPure is an unbuffered preservative free saline, available as 5ml vials in a
98-count box. It is available at https://www.meniconwebstore.com or
https://dryeyeshop.com.
Nutrifill is a preservative-free buffered saline with natural electrolytes. It comes
in a box of 35, 10ml ampules and is available at https://www.nutrifill.com,
https://www.myeyesupply.com, or https://www.dryeyeshop.com.
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Filling or Rinsing the Device
Below are 5 options for filling and rinsing PROSE devices:

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application
Filling or Rinsing the Device
Below are 5 options for filling and rinsing PROSE devices:
Rinsing Only
To save money, an option for RINSING ONLY is to use Bausch + Lomb
Sensitive Eyes Plus Saline Solution or Clear Care Rinse & Go. These solutions
contain preservatives and under NO circumstances should they be used to fill
PROSE devices. When using these solutions for rinsing, your PROSE devices
should be thoroughly rinsed with preservative-free saline.
Preservative-Free Saline Protocol, continued

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application — key points
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Your eye must be open WIDE – the lid spread is everything! See next page for examples.
The PROSE device must be centered within the lid spread.
The plunger must be vertical. Your PROSE device must retain the preservative-free saline
in the device to avoid bubbles.
Overfill your device to improve your chances of a bubble-free application. Let the saline
drip, not stream, into the device bowl.
Key Points for Optimal BostonSight PROSE Device Application
Wash your hands with non-moisturizing soap and dry them completely with a lint-free
towel before you begin.
Gently handle only the outside edges of the device.
• Your PROSE devices may have dots. For patients with devices for both eyes, the
RIGHT device is marked with ONE black dot. The LEFT device will have either NO
dots or TWO black dots.
• When either device has one or two black dots, the device should be applied with the
dot(s) oriented at the 12 o’clock position, unless otherwise instructed by your doctor.
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1 dot = Right 2 dots = Left
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Incorrect! Fingertips are not centered.
Lid spread is not a perfect circle.
Incorrect! Lids slipped from fingertips.
Lids are not open wide enough.
Perfect! A round opening with plenty of
clearance for the device application.
The Lid Spread is Everything
application – lid spread

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application – plunger
How to Apply Your PROSE Device with a Plunger
Empty the contents of the case (i.e. the PROSE device) into the palm of your hand. With
the other hand, GENTLY grasp the device by the edges. Note: the device should be wet
during this process.
Squeeze in on the sides of the plunger before coming into contact with the device.
Place the device over the face of the plunger, and release side pressure on plunger,
creating suction between the plunger and the device.
Release the sides of the device, holding it with the plunger.
IMPORTANT: Holding the device with the fingers while applying the plunger lessens the
force against the device. ALWAYS handle the device by the edges when attempting to
attach the plunger to the device. DO NOT attach the plunger while the device is resting on
a hard surface such as a table or counter top. This will place excessive force on the device,
risking breakage. Never squeeze the sides or place pressure on the face of the device.
IMPROPER USE OF PLUNGER DURING DEVICE APPLICATION
• DO NOT apply force with plunger in a downward motion causing device to break
• DO NOT use the plunger to contact the device while it is sitting on a hard surface
• DO NOT attempt to take a device out of the case with a plunger
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How to Apply Your PROSE Device with a Plunger, continued
Holding the plunger vertically, overfill device with preservative-free
saline. Let the solution drip, not stream into the device, in order to
prevent bubbles from forming.
Maintain proper lid spread. Hold the eyelids at the edges, where
the lashes meet the lids. The contact points should be centered
on both lids, so as to form a perfectly round opening with plenty of
clearance for device application.
Tuck your chin to your chest. Look straight down. Keep the
plunger centered in your eye by focusing on the black hole in
the center of the plunger.
Continue approaching your eye smoothly and steadily, and
stare at the black hole as if you are looking through it. Some
people find it useful to shut the eye that they are not apply-
ing the device to.
You will feel the fluid, but you are not there yet. Press your device
onto the eye with firm pressure.
Capture the device with the eyelids by releasing the lids. Don’t
squint. Maintain the upward pressure on the device while squeezing
the plunger in order to release the plunger from the device.
The device has now been released onto your eye! Continue
squeezing the plunger while you pull the plunger away from the eye.
Now check your device in the mirror. Shine a penlight, at an angle,
onto the surface of the device and look for the presence of any
bubbles in or under the device. If you detect bubbles the device
MUST be removed and reapplied.
After application of both devices, clean your application plunger
with warm soapy water, rinse well, and allow to air dry.
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application – plunger

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How to Apply Your PROSE Device with a Lighted Plunger
Wet the fenestrated end of the application plunger with
preservative-free saline. Attach the plunger to the plunger light
by inserting the light into the hole at the end of the fenestrated
plunger.
While holding a cleaned and disinfected PROSE device
gently by the edges, apply to an application plunger by gently
squeezing the plunger at the line while placing the device on
the cup and releasing the ‘squeeze’ to create suction. Refer
to page 8 for complete instructions. Turn on the green light by
pressing the black button.
Holding the plunger vertically, overfill device with
preservative-free saline. Let the solution drip, not stream into the device, in
order to prevent bubbles from forming.
Maintain proper lid spread. Hold the eyelids at the edges, where the lashes
meet the lids. The contact points should be centered on both lids, so as to
form a perfectly round opening with plenty of clearance for the device.
Tuck your chin to your chest. Look straight down. Keep the
plunger centered in your eye by focusing on the green light in
the center of the plunger.
Continue approaching your eye smoothly and steadily, and
stare at the green light as if you are looking through it. Some
people find it useful to shut the eye they are not applying the
device to.
You will feel the fluid but you are not there yet. Press your
device onto the eye with firm pressure.
Capture the device with the eyelids by releasing the lids. Don’t
squint. Maintain the upward pressure on the device while
squeezing the plunger in order to release the plunger from
the device.
The device has now been released onto your eye! Continue squeezing the
plunger while you pull the plunger away from the eye.
Check your device in the mirror. Shine a penlight, at an angle, onto the surface
of the device and look for the presence of any bubbles in or under the device.
If you detect bubbles the device MUST be removed and reapplied.
After application of both devices, clean your application plunger with warm
soapy water, rinse well, and allow to air dry.
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application – lighted plunger

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How to Apply Your PROSE Device with a Plunger Stand
With or Without a Lighted Plunger
Place the application plunger in the hole at the top of the stand. If using a light, feed the
wire through the slot on the stand. Turn on the light. Adjust the
height of the stand, if necessary, by placing it on top of
something such as a book or a tissue box.
While holding a cleaned and disinfected PROSE device gently
by the edges, place onto the application plunger. Do NOT
squeeze the plunger to attach the device; this will allow it to
release easily when applying.
Overfill device with preservative-free saline. Let the solution
drip, not stream into the device, in order to prevent bubbles
from forming.
Hold the eyelids at the edges, where the lashes meet the lids.
The contact points should be centered on both lids, so as to
form a perfectly round opening with plenty of clearance for
device application.
Tuck your chin to your chest. Look straight down. Keep the
plunger centered in your eye by focusing on the black hole or
green light in the center of the plunger.
Begin to approach the device by moving your head downward
smoothly and steadily. The approaching device and plunger
must be centered within that opening and your focus must
remain on the black hole or green light.Some people find it
useful to shut the eye that they are not applying the device to.
You will feel the fluid but you are not there yet. Continue the
downward motion until your device is pressed firmly against
your eye.
Capture the device with the eyelids by releasing the lids.
The device has now been released onto your eye! Keep your
eye closed while you sit up, backing away from the plunger with the device on your eye.
Now check your device in the mirror. Shine a penlight, at an angle, onto the surface of the
device and look for the presence of any bubbles in or under the device. If you detect bubbles
the device MUST be removed and reapplied.
After application of both devices, clean your application plunger with warm soapy water,
rinse well, and allow to air dry.
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application – plunger stand

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Examples of Bubbles Under Your PROSE Device
Single bubble:
Multiple bubbles:
If you see a bubble, the device MUST be removed and re-applied.
application – bubbles

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removal
How to Remove Your PROSE Device with a Plunger
You will need to have a soft towel to be placed on top of a clean work surface
where you will remove your device(s).
You will need the following supplies:
• A removal plunger
• A small mirror, positioned upright
• Preservative-free saline
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Set Up: PROSE Device Removal
Position the mirror upright on your work surface.
Lubricate your eye thoroughly with several drops of preservative-free
saline.
Wet a removal plunger with the preservative-free saline.
Look straight ahead into the mirror.
Just as when applying your PROSE device, execute proper lid spread.
It is important to make sure the upper lid is secure during the removal
to prevent scratching your eye.
While maintaining your lid spread, create suction with the plunger at
a 45 degree angle. Aim for the 6 o’clock position on the device, at the
point where the colored portion of the eye meets the white.
Press the removal plunger firmly but gently against the device. Break
the suction by tipping the bottom of the plunger up and then pull the
plunger in an arc-down-and-out manner, taking care not to scratch
your cornea. On some occasions, you may need to pull and relax the
plunger rapidly and repeatedly.
NOTE: If the plunger is pressed too close to the center of the device,
directly over the pupil, it may not be possible to break suction and
remove the device.
Maintain the lid spread until the device is out of your eye.
Hold the device gently by the edges and remove the plunger from the
device by twisting and maneuvering it towards the edge of the device.
Clean your removal plunger with warm soapy water, rinse well, and
allow to air dry.

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How to Remove Your PROSE Device without a Plunger
Lubricate your eye thoroughly with several drops of preservative-free saline.
Press the tip of an index finger on the very
edge of your upper lid at the 12 o’clock
position and gently push it into your eye just
above the top edge of the device. (If you have
deep-set eyes, this will require you to reach
under your brow and look slightly down.)
Block the device from moving down by pressing the tip of the
index finger of your other hand on the very edge of your lower lid
just below the bottom edge of the device.
Look upward until you feel the device being blocked by pressure
on the upper lid margin.
Scoop the upper edge of the device off the eye with the upper lid
margin, look up further, and blink slowly to remove the device.
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removal – without a plunger

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disinfection and care
• One PROSE case
• One unopened package of Clear Care
• Please note that you can use original Clear Care or Clear Care Plus
Remove the lid from the PROSE case.
Remove the lid from the small Clear Care case.
Remove/break off the catalyst from the arbor on the bottom of the Clear Care
case (as illustrated below).
Discard the Clear Care case.
*NEVER attempt to disinfect your PROSE device in the case included
with the Clear Care Solution
If your PROSE case still has the arbor (stem) attached to the bottom of the
basket assembly, it will need to be removed by using pliers to grasp the arbor
and gently bending the arbor until it breaks. If not, continue to step 6.
Drop the platinum disc from the Clear Care case into the PROSE case so that
it sits on the bottom of the PROSE case.
We recommend replacing the platinum disc every two months. Under NO
circumstances should the platinum disc be used for more than 90 days.
Your PROSE case is now properly set up for nightly disinfection.
Set Up: Your PROSE Case
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We recommend replacing your PROSE case every 3 months.
To start, you will need to have a clean work surface and the following supplies:

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You will need a soft towel to be placed on top of a clean work surface where
you will clean your device(s).
You will need the following supplies:
• A PROSE case with platinum disc from the Clear Care disinfection case
• Preservative-free saline
• MiraFlow, Sereine, Lens Fresh, Unique pH, Boston Simplus or Tangible
Clean* (*Tangible Clean is for Hydra-PEG devices only)
• One bottle of Clear Care or 3% hydrogen peroxide
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Set Up: PROSE Device Care and Cleaning
disinfection and care

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disinfection and care p.m.
Wash your hands thoroughly with non-moisturizing soap and dry completely with a
lint-free towel before you begin.
Place your device in the palm of your hand. Place one drop of your daily cleaner on the
outside surface of the device and rub for 15 seconds. Place another drop on the inner
surface and then rub again for 15 seconds.
DO NOT rub the device between your fingers to clean it. This can cause the
device to warp.
While handling the PROSE device gently by the edges, rinse the device thoroughly
with either preservative-free saline or Bausch + Lomb Sensitive Eyes Plus saline or
Clear Care Rinse & Go. Under no circumstances should tap
water be used for rinsing.
Gently separate the basket from the basket assembly by pulling
the tab located near the arbor so that the basket is horizontal.
Place the device, bowl side up, into the basket (see photo at
right for correct placement). While keeping the basket horizontal,
bring the basket assembly down onto the basket. To avoid
damaging or losing your PROSE devices, DO NOT
attempt to bring the basket up to the basket assembly.
Repeat for the left device and place into the empty basket.
Fill the PROSE case with Clear Care solution or 3% hydrogen
peroxide (H²O²)to the fill line. It is okay if the platinum disc floats up to
the top – the basket will push it back down.
Place the basket assembly in the case and secure the cover. DO NOT
over tighten the cover because the threads may split and break. It is okay
if the platinum disc does not sit flat at the bottom of the case. It will still
work properly even if it is wedged on the side of the case.
To properly allow the Clear Care or 3% hydrogen peroxide solution to
neutralize, devices must remain in the case for AT LEAST 6 hours.
NOTE: If you must remove the devices before the disinfection process has ended, rinse
them thoroughly with the saline. Then soak devices in fresh saline, in a clean contact
lens case, for at least 5 minutes. Repeat with fresh saline solution for an additional
5-minute soak. Rinse again with preservative-free saline before applying to your eye. If
using a screw top contact lens case, clean the case with an alcohol wipe and air dry.
Nightly Disinfection Protocol for Your PROSE Devices
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Clean PROSE device(s) with your daily cleaner by following steps 1-6 on prior page.
Rinse device(s) thoroughly with saline solution.
Fill the PROSE case with 3% hydrogen peroxide to the fill line.
Place the basket assembly in the case and secure the cover. DO NOT over tighten the cover
because the threads may split and break. To properly allow the solution to disinfect, devices
must remain in the case for AT LEAST 6 hours.
In the morning, remove device(s) from hydrogen peroxide.
Rinse the device(s) thoroughly with saline. Then soak device(s) in fresh saline, in a clean
contact lens case, for at least 5 minutes. Repeat with fresh saline solution for an additional
5-minute soak. Rinse again with preservative-free saline before re-applying to your eye.
NOTE: Brown bottle 3% hydrogen peroxide is NOT FDA approved for PROSE device
disinfection. It is not micro-filtered for impurities and does not contain stabilizing buffers or
salts like Clear Care. Some patients report redness and/or discomfort with its use. If at any
time while using 3% hydrogen peroxide you experience increased redness, burning, or pain,
discontinue usage and use ONLY Clear Care.
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Nightly Disinfection Protocol for Your PROSE Devices Using
3% hydrogen peroxide (H²O²)Without Clear Care Platinum Disc
disinfection and care p.m.

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disinfection and care a.m.
You will need to have a soft towel to be placed on top of a clean work surface where you
will apply your device(s).
You will need the following supplies:
• An application plunger
• A removal plunger
• A small mirror
• Preservative-free saline
After thoroughly washing and drying your hands with non-moisturizing soap and water,
remove your device from the PROSE case.
While holding a cleaned and disinfected device gently by the edges, briefly rinse with
preservative-free saline. Under no circumstances should tap water be used for
rinsing.
Apply device(s) to the eye(s) using your preferred application technique.
After each use, empty the PROSE case (being careful not to lose the platinum disc) and leave
it open to air dry. NEVER clean the PROSE case with alcohol.
NOTE: If you experience a slight stinging sensation upon application of the device in the
morning, remove your device from your eye immediately and rinse your eye thoroughly
with preservative-free saline. Do this until the stinging sensation dissipates. Rinse your
device(s) thoroughly with preservative-free saline and then soak them in fresh saline
solution for at least 5 minutes before re-applying to your eye. When this occurs, it is likely
an indication that the Clear Care catalyst needs to be replaced.
WARNING
Increased eye redness, pain, discharge, sensitivity to light, and/or significant reduction in
vision may signal infection and requires IMMEDIATE attention. Please contact your primary
eye care provider and ask them to keep your PROSE doctor aware of any findings.
Morning Protocol for Application of Your PROSE Devices
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Q: What are the daily essentials of my PROSE device(s)? Is there a smaller
carrying case available than the one provided?
Daily Essentials include:
• Preservative-free saline
• One clean contact lens case
• One application plunger
• One removal plunger
A small digital camera case or makeup bag, available at any major department store, should
fit your daily essentials.
Q: What kind of eye make-up can I use while wearing my BostonSight PROSE device(s)?
Please visit our website for a list of make-up options that are complimentary to PROSE
device wear.
https://www.bostonsight.org/wp-content/uploads/2020/09/Compatible-Makeup-List.pdf
Q: I have two PROSE devices. How can I distinguish between the left and the right device?
For patients with PROSE devices for both eyes, the RIGHT device is marked with ONE black
dot. The left device will have either NO dots or TWO black dots. The device should be ap-
plied with the dot(s) oriented at the 12 o’clock position, unless instructed otherwise by your
doctor.
Q: Can I sleep or nap in my PROSE device(s)?
You can nap for a maximum of 30 minutes. DO NOT sleep with your PROSE devices, as this
can greatly increase the risk of an eye infection.
Q: What should I do with my PROSE device(s) if I remove them for a short period of
time to shower, swim, or nap?
Devices should be placed in a screw top contact lens case with either Unique pH or Boston
Simplus. Before re-applying, the PROSE device(s) should be cleaned with your daily cleaner
and rinsed well with preservative-free saline. The case should then be emptied, wiped out with
an alcohol prep pad, and allowed to air dry.
Q: Can I swim or shower while wearing the PROSE device(s)?
No, you cannot swim or shower while wearing PROSE devices. Exposure to impure and non-
sterile water (tap, lake, pool, etc) while wearing your PROSE device increases your risk of a
sight-threatening infection. For any further specific questions regarding this, please speak to your
PROSE doctor.
faq - PROSE device use