Alternative Technique for Custom Ocular Prosthesis

OCULAR
PROSTHESIS

An alternative technique

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com


INTRODUCTION


Ocular prosthesis is a modality of facial
prosthesis that aims to repair total or partial
ocular bulb losses or deformities.


The main goals are toRestore facial esthetics,
Prevent eyelid collapse and deformity,
Protect the socket against injuries caused by
foreign bodies, dust and smoke,
Re-establish the correct route of the
lachrymal secretion to prevent accumulation
in the cavity, and
Preserve muscular tonus to avoid antisymmetrical alterations.

History


The eye was a symbol of life
to the ancient world,
particularly in Egypt, where
bronze and precious stone
eyes were placed on the
deceased.
 The Romans decorated
statues with artificial eyes
made of silver.


 Ambrose Paré (1510-1590), a famous
French surgeon, was the first to describe
the use of artificial eyes to fit an eye socket.
These pieces were made of gold and silver.




Enamel prostheses (1820s1890s) were attractive but were
expensive and not very durable.



The introduction of cryolite
glass, made of arsenic oxide
and cryolite from sodiumaluminum fluoride (Na6A2F12),
produced a grayish-white color
suitable for a prosthetic eye.



German craftsmen are credited
with this invention in 1835.



To make these glass eyes, a tube of glass
was heated on one end until the form of a
ball was obtained. Various colors of glass
were used like paintbrushes to imitate the
natural color of the eye



The glass art form flourished in France
and Germany where fabricating secrets
were handed down from one generation
to the next.




The town of Lausche, Germany, had a
particularly rich history in both decorative
(doll eyes, Christmas ornaments) and
prosthetic arts.



In the 19th century, German craftsmen
("ocularists") began to tour the United
States and other parts of the world,
fabricated eyes and fit them to patients.



Stock eyes (or pre-made
eyes) were also utilized.
An "eye doctor" might
keep hundreds of glass
stock eyes in cabinets, and
would fit patients with the
best eye right out of the
drawer.




In the United States, eyes continued to be
made of glass until the onset of World War
II, when German goods were limited and
German glass blowers no longer toured the
United States.



The United States military, along with a
few private practitioners, developed a
technique of fabricating prostheses using
oil pigments and plastics. Since World War
II, plastic has become the preferred
material for the artificial eye in the United
States.




By the mid-1940s, glass
eyes were being replaced
by plastic counterparts.



In Virginia, this was led
by Joseph Galeski
(of Richmond, Virginia),



Although American Optical
and several military
hospitals started to
experiment and dispense
plastic artificial eyes.




An ocular implant
replaces the lost volume
of the natural eye. The
first account of placing
an implant in the socket,
following enucleation,
was in 1841.



Implants have been
made of many different
materials, shapes, and
types throughout the
years. It also helps the
artificial eye to have
some degree of
movement

A Case Report


Examination Of The Socket


Examination of the stock eye


Indexed cast with stock eye


Putty cope


Impression tray


Injecting the impression material


Final impression


Double alginate technique


Stock eye shells


Wax try in


Flasking


Dewaxing


Customizing the shade guide


Packing


Finished prosthesis- External surface


Finished prosthesis– Tissue surface


Pre-prosthetic

Post-prosthetic


Stock eye


Custom eye

A custom ocular prosthesis
Advantages
– Improved adaptation to underlying tissues,
– Increased mobility of the prosthesis,
– Improved facial contours, and
– Enhanced esthetics gained from control
over the size of the iris, color of the iris
and sclera.

Disadsvantage
– It is more expensive than a stock
prosthesis, and several steps are required
for its fabrication

1. Never clean or soak your artificial eye in
rubbing alcohol because it will crack and
destroy the ocular prosthesis.
2. Remove the ocular prosthesis only as
necessary. Too much handling can cause
socket irritation and result in excessive
secretions.
3. If you remove your ocular prosthesis, be
sure to store it in water or soft contact
lens saline solution. This will keep deposits
from drying on the surface.

4.To clean your prosthesis, use an
antibacterial soap. Wash the eye between
your fingertips.
5.If you wish to or need to rinse out the
socket, use sterile saline with bulb
syringe.
6.Any eye drops can be used with the
artificial eye in place.
7.Visit at least once a year or more often
to have your ocular prosthesis checked,
cleaned and polished.

Conclusion
The use of custom-made ocular prosthesis
has been a boon to the patients. The
esthetic and functional outcome of the
prosthesis was far better then the stock
ocular prosthesis.

Although the patient cannot see with this
prosthesis, it has definitely restored his
self-esteem and allowed him to confidently
face the world rather than hiding behind
dark glasses.

Thank you
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Alternative Technique for Custom Ocular Prosthesis

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