OCULAR PROSTHESIS

Introduction

A custom made ocular prosthesis is made to replace an absent natural eye following surgical enucleation, evisceration, or orbital exenteration. Customized prosthesi is manufactured from high-grade acrylic as perpatient’s socket measurement, iris color.

Indication of Custom Artificial Eye

Congenital Conditions:

• Microphthalmia
• Clinical anophthalmia

Acquired Conditions:

• Anophthalmia post evisceration/enucleation
• Phthisis bulbi
• Atrophic globes
• Painless blind eyes
• Severely deformed socket
• Post orbital exenteration
• Severe oribital trauma

Durability

HDMG PMMA has high impact resistance to breakage. The material can be scratched or damaged if dropped or scraped on hard, rough surfaces. The material can be resurfaced, buffed and polished to remove minor scratches, etc. Pigments are chemically bonded and cured to assure integrity of prosthesis colour.

Ocular Prosthesis

Also known as an artificial eye, is a plastic prosthesis used when an eye is surgically removed. During surgery, a ball implant is inserted into the eye socket to fill the area the eye once occupied. An ocular prosthesis is then molded to fit in front of the implant. It occupies the space between the eyelids and the skin (conjunctiva) covering the implant.

The ocular prosthesis is generally made four to six weeks after surgery in order to allow the socket tissues to heal adequately. Prior to that time, a thin plastic plate, called a conformer, is sometimes worn in place of the prosthesis. This prevents shrinkage of the tissue and helps to prepare the socket for ocular placement.

Until the ocular prosthesis is fitted, the upper eyelid can be droopy in appearance. The prosthesis will help support the eyelid and allow the lids to open and close normally.

Scleral Cover Shell Prosthesis

Also known as a “cover shell,” is a thin, plastic prosthesis used when an eye is malformed as a result of a birth defect, or becomes non-functioning due to subsequent illness or injury. In such cases, the non-functioning eye is left within the eye socket. Prosthesis can then be molded to fit between the lids and the blind eye.

Scleral cover shells fit directly over the malformed eye. Sometimes a “trial shell” is fashioned to allow the eye to grow accustomed to the direct contact of the prosthesis.

Cover shells impart a better cosmetic appearance by closely resembling the remaining good eye, while leaving the affected eye in the socket.

Orbital with Ocular Prosthesis

An orbital with ocular prosthesis artificially restores the eye, eyelids, and the adjacent hard and soft tissues which have been lost as a result of a radical surgery (exenteration) or traumatic event. It protects the exposed orbital, nasal and sinus tissues from the elements; restores normal speech patterns when the nasal and sinus areas are involved; maintains normal humidity and moisture for the maxillary sinus, oral, and nasal cavities; houses the artificial eye; and restores the normal appearance of the face.

The process of designing and fabricating an ocular prosthesis requires multiple clinic visits, which may be lengthy, as well as numerous hours of laboratory work. The following steps will be necessary:

Step 1: The creation of a custom ocular prosthesis begins with an impression (mold) to duplicate the affected area (eye socket). The impression is made by injecting a molding agent into the socket. Once set, the mold is removed from the socket.

Step 2: From the mold, a wax model is made to try in the socket. Wax is used because it can be easily changed and carved or added to quickly. The goal is lid symmetry and movement of the wax model.

Step 3: Once this symmetry is achieved, the wax model is cast into a plaster mold and an acrylic duplicate is made.

Step 4: With the patient present in the lab, the future prosthesis is painted to match the fellow eye. The process continues until an exact colour match is achieved.

Step 5: The prosthesis is polished to a high gloss.

Step 6: The prosthesis is delivered to the patient.

Custom Artificial Eye Care Information:

Yearly Checkups – It is recommended that you return to our clinic once a year to have your prosthesis polished. Usually there is a significant build-up of salt and protein deposits on the eye in one year’s time. Polishing removes these potentially irritating deposits. The ocularist will also evaluate the eye’s fit and appearance. Sometimes a build-up or adjustment may be called for, due to subtle changes in the eye’s socket tissue.

Removal and Cleaning – At one time, all artificial eye wearers were told to remove and clean the prosthesis on a regular basis. It has since been learned that removal on a regular basis keeps the eye socket mildly irritated. Today’s artificial eyes generally need less attention due to improved fitting and polishing techniques. Many people do not feel the need to remove their prosthesis between visits to their ocularist. Removal and reinsertion of the prosthesis is an easy process. Our ocularist can show you the correct method. If you do remove your artificial eye, be sure to thoroughly wash your hands first; this will reduce the risk of infection and irritation.

Eye Drops – A few artificial eye wearers experience “dry eye” due to lack of lubrication. In such cases the ocularist will often recommend an aqueous lubricating solution such as artificial tears. In cases where the individual cannot close the eyelids all the way or the eyelids do not close during sleep, an oily lubricant may be recommended.

Storing the Eye – If the plastic eye must be left out of the socket overnight or longer for any reason, store it in water or in a contact lens soaking solution.

Other Points to Remember

• If you must rub the eye, rub towards the nose with the eyelids closed. Wiping away from the nose may cause the eye to fall out.
• Do not expose the plastic eye to alcohol, ether, chloroform, or any solvents. These may damage the plastic beyond repair.
• Most people can wear their artificial eye safely while swimming. However, to prevent accidental loss you may either wear swim goggles or remove the eye and store it safely.
• Protect your remaining eye by wearing protective glasses.

TESTIMONIAL