Ocular Prostheses

Ocular prostheses (artificial eyes) are used when the patient’s own eye has been removed (enucleated or eviscerated). The loss of the eye leads, in addition to the aesthetic change, to a retraction of the conjunctival sac and to deformities due to palpebral adhesions, for which reason the use of an ocular prosthesis is advisable. Although there are already manufactured prostheses (stock), it is best to make an exact mold of the socket to obtain a custom-made
ocular prosthesis. Our ocular prostheses are made to measure in a material composed of acrylic resins, approved for medical use according to European directives.

Among the most difficult problems encountered in the manufacture of ocular prostheses are the proper configuration of the pupil and the colouration of the iris, with its smooth transition, without net limits, towards the white of the eye. The ocular prosthesis, the manufacture of which is truly an art, must resemble the living eye as much as possible. This is not intended to attract attention as a specialized aesthetic work, if not precisely the opposite: we want the existence of a surgery to go completely unnoticed. For such reason it is necessary that patients visit us in our cabinet in more than one occasion so that the adaptation of a custom-made ocular prosthesis is successful.

In the first visit we proceed to take the measurements of the eye and extract an identical mold of the area to be treated. During the second visit, the mold that has been made is tested and colour tests are made. The objective of this visit is to achieve a correct centering and and exact colour. To ensure that every detail is of the highest quality, we need the presence and collaboration of the patient. In the third visit, the final retouches are made to the prosthesis.

Types of protheses

Entire prosthesis
It is the appropriate in the case of patients with enucleated, eviscerated or dermo-fat grafts. It consists in making an exact mold of the ocular cavity. This type of prosthesis provides better volume and mobility; it also avoids the formation of exudates as there are no free spaces between the prosthesis and the cavity.

Hollow prosthesis (husk)
Indicated in the case of enucleated or eviscerated patients with implants. They are also made from an exact mold of the ocular surface that will shape the implant. The prosthesis rests uniformly on the implant, distributing the pressure points. This type of prosthesis offers many advantages:

  • Less weight and more volume, which facilitates a correct plane reducing possible enophthalmos. A correct centering is also achieved, thus increasing the sensation of naturalness and similarity (iris colour, sclera, veins, etc.) with respect to the healthy eye.
  • Mayor movilidad, gracias a que los puntos de presión están uniformemente repartidos respecto al implante. Así se transmite en su otalidad la movilidad del implante, consiguiendo un efecto completamente bilateral.

Use and Maintenance

    1. Wash your hands before handling the ocular prosthesis.
    2. At night, remove the prosthesis by looking up and pressing on the lower eyelid.
    3. Pour a few drops of cleanser into the palm of your hand and rub the prosthesis for 10-20 seconds.
    4. Rinse thoroughly with the sterile solution.

 

  • To place the prosthesis in the eye:
    • Look down
    • Insert the prosthesis by placing it under the upper eyelid
    • Look up and fit the prosthesis with the lower eyelid

 

Precautions

  1. Use the solutions recommended by your specialist.
  2. Before changing maintenance solutions, consult your specialist.
  3. Do not expose to direct sunlight.
  4. In case of persistent discomfort or redness of the eye, stop using the prosthesis and consult your specialist.
  5. The estimated duration of an ocular prosthesis, except in specific cases, is 4 years. It is advisable to go for a check-up every year as a minimum and it will be your specialist who dictates the state of your ocular prosthesis.

FAQ (Frequently Asked Questions)

It may be due to the fact that you are wearing a prosthesis that is not custom-made (stock product) that leaves spaces between the prosthesis and the ocular socket where exudates accumulate. To eliminate these spaces covering homogeneously the ocular socket, it is advisable to have an ocular prosthesis made to measure with previous moulding of your ocular socket.

To remove the prosthesis: Looking up, press on the lower eyelid.
To place the prosthesis: Looking down, insert the prosthesis under the upper eyelid, then look up and fit the prosthesis with the lower eyelid.

Yes, daily cleaning is recommended.

Those recommended by your specialist.

Before changing maintenance solution consult your specialist as it may be incompatible with your ocular prosthesis.

Do not expose the prosthesis directly to the sun as it may lose colour.

It depends on the type of prosthesis. Your specialist will tell you.

The duration of an ocular prosthesis, except in special cases, is 4 years.

It is advisable to for a minimum check-up every year and it will be your specialist who will determine the state of your ocular prosthesis.

Cases

A really complicated job. The patient has a totally insufficient cavity: he lacks a sack bottom (that is, volume); the difficulty is also increased by the presence of an accentuated enophthalmos (the cavity is completely behind the functional eye) and a severe entropion (the eyelids fold inwards).
In the first instance, the severe entropion is corrected and a shape that fits into the cavity is adapted. It is evident that it manifests a supraorbital sinking due to its severe anophthalmia, but we must allow the cavity to widen to increase volume.

The type of case that provides the most satisfaction both professionally and personally is the successful fitting of an ocular prosthesis in babies. First because they are charming, and second… because it is usually a miracle that they let themselves touch the eye.
Certainly, this is a real challenge and a great responsibility for the professional. It is complicated, but it is possible.