Ocular Prosthesis

Articles

Disfigured eye is not only a cosmetic problem rather it also has noticeable impact on the personal and professional life of the patient as well as their family. Innovations in Ocularistry and Ophthalmic plastics surgery can help in successful rehabilitation of these patients. The artificial eye is a art that has several significance functions.

Different Ocular Prosthesis Services:

  1. Conformer Therapy
  2. Custom Ocular Prosthesis
  3. Custom Sclera shell
  4. Orbital Prosthesis   
  5. 3D limbus structure
  6. 3D appearance of iris painting
  7. Full detailing of structure
  8. High grade multi stage polishing

It is important to know that it doesn’t restore sight, but it does help to do the following:

  1. Prevent remaining soft tissue from collapsing
  2. Prevent eyelids and lashed from turning in.
  3. Facilitate the proper circulation of tears as they can continue to do their job of cleaning and lubricating the socket and lids.
  4. Regular ocular as well as orbital growth specially in children.

We are concerned with the comfort as well as the cosmetic appearance of the patient. Thus we make the prosthesis by taking custom impression of eye socket individually to fit appropriate size and shape of the eye.

Frequently Asked Questions:

What are the indications of Artificial Eye ?

  1. Absent eye following surgery (Anophthalmic Socket)
  2. Small disfigured eye following trauma (Phthisis Bulbi)
  3. Small eye since birth (Microphthalmos)
  4. Absent eye ball since birth (Congenital Anophthalmos)

What can an artificial eye do for one-eyed patient?

It can eliminate physical discomfort caused by the disfigured eye and abnormally placed eyelids. A good matching artificial eye can lessen the psychological hurt of an eye loss and disfigured eye.

What the differences between “stock” and “custom” eyes?

“Stock” or “ready-made” eyes are mass produced. Since a “stock eye” is not made for any particular person, it doesn’t fit and match any particular patient. A “custom” ocular prosthesis, on the other hand is made by taking individual customized Impression by well trained Ocularist to fit and match maximum cosmesis of the particular patient.

Custom made eyes are more comfortable and have better resemblance to the other eye apart form the advantage of continuous wear and better motility of the prosthesis. Whereas the ready-made eye suffers from discharge, discomfort, poor matching, lens movement, restricted wearing period, lower lid slugging and contracted socket as a result in future.

What is the advantage of “Custom-made” eyes over “stock” eyes?

Does this custom made artificial eye need daily removal and cleaning?

No. We make our artificial eyes by modified impression technique that eliminates discharge collection in the socket. Therefore, there is no need to remove it daily. It can be worn for months continuously. Patients can sleep without removing the ocular prosthesis.

Fabrication of Custom Made Prosthesis

Prosthetic eyes are made of an acrylic plastic material called poly methyl methacrylate (PMMA). It can be formed into any size and shape, it’s durable and is well tolerated by the surrounding eye tissues. The Prosthesis is made through the following series of steps:

  1. The process begins by taking an impression of the eye socket by silicone polymer to duplicate ocular socket. The impression of the eye socket is used to make a wax model. Using the wax model, we determine the correct position of the iris and the extent to which the eyelids will open.
  2. The wax model is then used to prepare a master mold which is filled with acrylic plastic to create a cast of the prosthesis.
  3. The iris button is hand painted form direct observation of the unaffected eye.
  4. This white acrylic is further colored and vessels are added to simulate its natural appearance. It is then covered with a clear plastic protective coating and is cured once more.
  5. The prosthesis is now ready after a high grade multi stage polishing to give it a perfectly smooth and we-looking appearance.

Author

Mr Ravi Shankar Chaudhary B.Optm (WBUT),
FLVPEI (Oculoplasty and Ocularistry)
University 3rd topper, Bronze Medal winner
 Consultant Optometrist and Ocularist 
Dhristi Eye care
Kalanki, Kathmandu, Nepal

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