Ocular prosthesis / fixed orthodontics long term courses

OCULAR OCULAR PROSTHESISPROSTHESISAn alternative techniqueAn alternative technique

INDIAN DENTAL ACADEMY

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INTRODUCTIONINTRODUCTION


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



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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 were 1890s) were attractive but were expensive and not very durable.expensive and not very durable.

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

German craftsmen are credited German craftsmen are credited with this invention in 1835.with this invention in 1835.


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

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


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

In the 19th century, German craftsmen In 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-made Stock eyes (or pre-made eyes) were also utilized. An eyes) were also utilized. An "eye doctor" might keep "eye doctor" might keep hundreds of glass stock hundreds of glass stock eyes in cabinets, and eyes in cabinets, and would fit patients with the would fit patients with the best eye right out of the best eye right out of the drawer.drawer.


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

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


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

In Virginia, this was led In Virginia, this was led by Joseph Galeski by Joseph Galeski

(of Richmond, Virginia),(of Richmond, Virginia),

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


An ocular implant An ocular implant replaces the lost volume replaces the lost volume of the natural eye. The of the natural eye. The first account of placing first 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 been Implants have been made of many different made of many different materials, shapes, and materials, shapes, and types throughout the types throughout the years. It also helps the years. It also helps the artificial eye to have artificial eye to have some degree of some 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


Double alginate technique Double alginate technique


Stock eye shellsStock eye shells


Wax try inWax try in


Flasking Flasking


Dewaxing Dewaxing


Customizing the shade guide Customizing 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 prosthesis A custom ocular prosthesis

Advantages Advantages – 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 control Enhanced esthetics gained from control

over the size of the iris, color of the iris and over the size of the iris, color of the iris and sclera. sclera.

DisadsvantageDisadsvantage– It is more expensive than a stock It is more expensive than a stock

prosthesis, and several steps are required prosthesis, and several steps are required for its fabricationfor its fabricationwww.indiandentalacademy.comwww.indiandentalacademy.com

1. Never clean or soak your artificial eye in 1. Never clean or soak your artificial eye in rubbing alcohol because it will crack and rubbing alcohol because it will crack and destroy the ocular prosthesis.destroy the ocular prosthesis.

2. Remove the ocular prosthesis only as 2. Remove the ocular prosthesis only as necessary. Too much handling can cause necessary. Too much handling can cause socket irritation and result in excessive socket irritation and result in excessive secretions. secretions.

3. If you remove your ocular prosthesis, be 3. If you remove your ocular prosthesis, be sure to store it in water or soft contact sure to store it in water or soft contact lens saline solution. This will keep deposits lens saline solution. This will keep deposits from drying on the surface.from drying on the surface.


4.To clean your prosthesis, use an 4.To clean your prosthesis, use an antibacterial soap. Wash the eye between antibacterial soap. Wash the eye between your fingertips. your fingertips.

5.If you wish to or need to rinse out the 5.If you wish to or need to rinse out the socket, use sterile saline with bulb socket, use sterile saline with bulb syringe. syringe.

6.Any eye drops can be used with the 6.Any eye drops can be used with the artificial eye in place.artificial eye in place.

7.Visit at7.Visit at least once a year least once a year or more often or 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


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Ocular prosthesis / fixed orthodontics long term courses

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