For a patient who is unfortunate enough to lose an eye to disease or trauma, the pain extends beyond the loss of the function itself. The continued suffering of a painful or disfigured eye, the social stigma, all lead to psychological setbacks for the patient.
We are, therefore, happy to announce the setting up of Ocularistry Service at SunEye Hospital Lucknow, where we offer custom-made ocular prosthesis, which make for superior user-comfort and cosmesis as close to the natural eye as possible.
CUSTOM MADE OCULAR PROSTHESIS
- Any patient who has an anophthalmic socket may benefit from custom made prosthesis- this may be post-surgical, after enucleation, evisceration, or orbital exenteration.
- The surgery may have been performed for a condition of intra-ocular tumor, infection, or trauma: none of these conditions is a contraindication for fitting of a custom prosthesis.
- A disfigured blind eye with volume loss such as with phthisis bulbi can receive a custom-prosthesis.
- A painful blind eye, or an anterior staphyloma can receive a prosthesis after preliminary surgery.
- Congenital anomalies such as severe microphthalmos or anophthalmos can also be fitted with a custom prosthesis.
- A patient who has been previously using stock eyes, experiencing irritation, pain or discharge would also benefit from superior cosmesis, motility and wearer comfort of the custom prosthesis.
- Patients on stock eyes who show enophthalmic appearance, squint, or defective closure of the lids will have improved appearance with a custom made eye.
- Pre-Fitting Assessment.
- Before fitting of the custom prosthesis, the socket is assessed to ensure it is healthy. There should not be any active infection or inflammation, excessive tenderness or sensitivity. The space available must be adequate, and the fornices well formed to support the prosthesis.
- The patient should report for an assessment of the socket or eye before the appointment for prosthesis is fixed, and any condition requiring treatment will be managed. A customised prosthesis may be fitted in most situations without further surgery. However, prior surgical procedures may be necessary in selected cases.
THE ESSENTIALS (THE PROCEDURE)
- Once the socket is assessed and found healthy, an impression is taken from the socket with alginate.
- A wax model of the eye is made, and the fit and centration determined.
- The white eye is fabricated from acrylic, which is biocompatible.
- The iris color, scleral color are matched to be identical to the other eye.
- After a final coating of clear acrylic, the eye is polished and dispensed.
CUSTOMIZED PROSTHESIS
Before and After customized prosthesis implantation
FABRICATED CUSTOM MADE OCULAR PROSTHESIS
The newer technique involves taking the patient’s actual photograph using a digital camera (Canon EOS Digital Rebel) with a Macro lens and a ring light flash.
The photograph is then evaluated and compared with the patient’s iris and minor touchups are done in Adobe Photoshop version 7.0.
The photograph printout is taken on a paper which is then covered by 3 layers of water-resistant spray. The same is then mounted on an ocular disc.
This is then fixed in a wax mould and evaluated in the patient’s socket to look for comfort and fit.
If found suitable, it is reprocessed with clear acrylic, polished and finalized.
ADVANTAGES
- Better Aesthetic result as it closely resembles the patient’s own iris.
- Simpler procedure- requires minimal artistic skills.
- Decreased prosthesis fabrication time.
- Better objective evaluation of prosthesis outcome.
CARE FOR THE CUSTOM PROSTHESIS
As the customized prostheses are manufactured from high-grade acrylic, they are extremely durable. Very little special care is required.
- Once the patient is accustomed to the eye, it can be worn continuously, to be removed and cleaned once a week.
- Pediatric age group, a profession involving heavy physical activity or long outdoor hours are NOT contraindications for customized ocular prostheses.
- The use of the custom prosthesis does not cause harm to the other eye.
- Custom prosthesis can be used for many years. Annual follow-up with the ocularist for polishing of the surface prolongs the usable life of the prosthesis.
- Benefit of Customised Prosthesis over available stock eyes.
- In difficult sockets, where commercially available stock eyes do not fit, customized prosthesis is the procedure of choice.
- Will not show volume disparity or centration defect (squint) unlike stock eye.
- Superior matching of iris colour, iris size, scleral colour.
- Superior prosthesis motility.
- High quality materials with superior polished surface eliminate the conjunctival irritation and discharge often associated with stock eye.
Higher durability over years and resistance to impact-breakage.