Ocular prosthesis / fixed orthodontics long term courses

OCULAROCULAR
PROSTHESISPROSTHESIS
An alternative techniqueAn alternative technique
INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.com
www.indiandentalacademy.comwww.indiandentalacademy.com

INTRODUCTIONINTRODUCTION

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 anti-
symmetrical 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 (1820s-Enamel prostheses (1820s-
1890s) were attractive but were1890s) were attractive but were
expensive and not very durable.expensive and not very durable.
 The introduction of cryoliteThe introduction of cryolite
glass, made of arsenic oxideglass, made of arsenic oxide
and cryolite from sodium-and cryolite from sodium-
aluminum fluoride (Na6A2F12),aluminum fluoride (Na6A2F12),
produced a grayish-white colorproduced a grayish-white color
suitable for a prosthetic eye.suitable for a prosthetic eye.
 German craftsmen are creditedGerman craftsmen are credited
with this invention in 1835.with this invention in 1835.

 To make these glass eyes, a tube of glassTo make these glass eyes, a tube of glass
was heated on one end until the form of awas heated on one end until the form of a
ball was obtained. Various colors of glassball was obtained. Various colors of glass
were used like paintbrushes to imitate thewere used like paintbrushes to imitate the
natural color of the eyenatural color of the eye
 The glass art form flourished in FranceThe glass art form flourished in France
and Germany where fabricating secretsand Germany where fabricating secrets
were handed down from one generationwere handed down from one generation
to the next.to the next.

 The town of Lausche, Germany, had aThe town of Lausche, Germany, had a
particularly rich history in both decorativeparticularly rich history in both decorative
(doll eyes, Christmas ornaments) and(doll eyes, Christmas ornaments) and
prosthetic arts.prosthetic arts.
 In the 19th century, German craftsmenIn the 19th century, German craftsmen
("ocularists") began to tour the United("ocularists") began to tour the United
States and other parts of the world,States and other parts of the world,
fabricated eyes and fit them to patients.fabricated eyes and fit them to patients.

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

 In the United States, eyes continued to beIn the United States, eyes continued to be
made of glass until the onset of World Warmade of glass until the onset of World War
II, when German goods were limited andII, when German goods were limited and
German glass blowers no longer toured theGerman glass blowers no longer toured the
United States.United States.
 The United States military, along with aThe United States military, along with a
few private practitioners, developed afew private practitioners, developed a
technique of fabricating prostheses usingtechnique of fabricating prostheses using
oil pigments and plastics. Since World Waroil pigments and plastics. Since World War
II, plastic has become the preferredII, plastic has become the preferred
material for the artificial eye in the Unitedmaterial for the artificial eye in the United
States.States.

 By the mid-1940s, glassBy the mid-1940s, glass
eyes were being replacedeyes were being replaced
by plastic counterparts.by plastic counterparts.
 In Virginia, this was ledIn Virginia, this was led
by Joseph Galeskiby Joseph Galeski
(of Richmond, Virginia),(of Richmond, Virginia),
 Although American OpticalAlthough American Optical
and several militaryand several military
hospitals started tohospitals started to
experiment and dispenseexperiment and dispense
plastic artificial eyes.plastic artificial eyes.

 An ocular implantAn ocular implant
replaces the lost volumereplaces the lost volume
of the natural eye. Theof the natural eye. The
first account of placingfirst account of placing
an implant in the socket,an implant in the socket,
following enucleation,following enucleation,
was in 1841.was in 1841.
 Implants have beenImplants have been
made of many differentmade of many different
materials, shapes, andmaterials, shapes, and
types throughout thetypes throughout the
years. It also helps theyears. It also helps the
artificial eye to haveartificial eye to have
some degree ofsome degree of
movementmovement

A Case ReportA Case Report

Examination Of The SocketExamination Of The Socket

Examination of the stock eyeExamination of the stock eye

Indexed cast with stock eyeIndexed cast with stock eye

Putty copePutty cope

Impression trayImpression tray

Injecting the impression materialInjecting the impression material

Final impressionFinal impression

Double alginate techniqueDouble alginate technique

Stock eye shellsStock eye shells

Wax try inWax try in

FlaskingFlasking

DewaxingDewaxing

Customizing the shade guideCustomizing the shade guide

PackingPacking

Finished prosthesisFinished prosthesis-- External surfaceExternal surface

Finished prosthesisFinished prosthesis–– Tissue surfaceTissue surface

Pre-prosthetic Post-prostheticPre-prosthetic Post-prosthetic

Stock eye Custom eyeStock eye Custom eye

A custom ocular prosthesisA custom ocular prosthesis
AdvantagesAdvantages
– Improved adaptation to underlying tissues,Improved adaptation to underlying tissues,
– Increased mobility of the prosthesis,Increased mobility of the prosthesis,
– Improved facial contours, andImproved facial contours, and
– Enhanced esthetics gained from controlEnhanced esthetics gained from control
over the size of the iris, color of the irisover the size of the iris, color of the iris
and sclera.and sclera.
DisadsvantageDisadsvantage
– It is more expensive than a stockIt is more expensive than a stock
prosthesis, and several steps are requiredprosthesis, and several steps are required
for its fabricationfor its fabricationwww.indiandentalacademy.comwww.indiandentalacademy.com

1. Never clean or soak your artificial eye in1. Never clean or soak your artificial eye in
rubbing alcohol because it will crack andrubbing alcohol because it will crack and
destroy the ocular prosthesis.destroy the ocular prosthesis.
2. Remove the ocular prosthesis only as2. Remove the ocular prosthesis only as
necessary. Too much handling can causenecessary. Too much handling can cause
socket irritation and result in excessivesocket irritation and result in excessive
secretions.secretions.
3. If you remove your ocular prosthesis, be3. If you remove your ocular prosthesis, be
sure to store it in water or soft contactsure to store it in water or soft contact
lens saline solution. This will keep depositslens saline solution. This will keep deposits
from drying on the surface.from drying on the surface.

4.To clean your prosthesis, use an4.To clean your prosthesis, use an
antibacterial soap. Wash the eye betweenantibacterial soap. Wash the eye between
your fingertips.your fingertips.
5.If you wish to or need to rinse out the5.If you wish to or need to rinse out the
socket, use sterile saline with bulbsocket, use sterile saline with bulb
syringe.syringe.
6.Any eye drops can be used with the6.Any eye drops can be used with the
artificial eye in place.artificial eye in place.
7.Visit at7.Visit at least once a yearleast once a year or more oftenor more often
to have your ocular prosthesis checked,to have your ocular prosthesis checked,
cleaned and polished.cleaned and polished.

ConclusionConclusion
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.www.indiandentalacademy.comwww.indiandentalacademy.com

Ocular prosthesis / fixed orthodontics long term courses

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (20)

Similar to Ocular prosthesis / fixed orthodontics long term courses

Similar to Ocular prosthesis / fixed orthodontics long term courses (20)

More from Indian dental academy

More from Indian dental academy (20)

Recently uploaded

Recently uploaded (20)

Ocular prosthesis / fixed orthodontics long term courses

Editor's Notes