Custom Ocular Prosthetics
There are several different surgeries used by ophthalmologists, to create the best anatomical eye socket possible. The surgical technique to remove an eye is referred to as an enucleation. The surgical technique to remove the contents of an eye is referred to as an evisceration. Both procedures will require the fitting of a custom artificial eye. This is a restoration process, usually beginning approximately 6 weeks following the surgery.
Fitting the prosthetic eye begins with our ocularist making an impression mold of the eye socket, or contents in the eye socket. This procedure assures each patient with the maximum amount of comfort and movement available, with the ability of the implant and surgical technique.
Our Ocularists have developed advanced art techniques that recreate the most life-like appearance possible. We focus on matching eyelid contours, eyelid folds, and many other factors involved in achieving symmetry. All efforts are made to maximize the amount of movement, and to create an exact color match. We use only earth pigmented oil paints and tones in our prostheses. This enables our ocularist to provide the finest detail with depth of color and vibrancy in our patient’s prosthesis for many years. Our dedication is with you and your referring physician to develop the highest level of care possible.
Scleral Shell Prosthetics
A Scleral Shell Prosthesis is a thin, hard acrylic, shell-like artificial eye, which is designed to be worn over a discolored and/or disfigured eye. It covers the entire surface of the blemished eye, restoring a natural appearance. There is no surgery involved in obtaining a Scleral Shell Prosthesis, just a few visits to our office.
Our focus in the fitting process, is to provide you with a natural appearance by making an exact color match, and by maximizing movement of the prosthesis.
At approximately 4-6 weeks following enucleation and an office referral from the doctor, the process begins with a consultation, which provides an opportunity for your child to become comfortable with our ocularist. Depending on the reaction from the patient, we may take things to the next step and try to fit the patient that same day.
We are sensitive to the needs of each patient and family. We will do our best to fully explain what will take place during their visit at our office. It is important for the ocularist and parents to limit their expectations of what will be accomplished during the first visits. Our office provides a “one day” service to all patients, even shell patients.
Follow-up visits for infants and toddlers receiving a prosthesis are scheduled approximately every 2-4 months. In some cases, one-month intervals are used, in order to keep a close watch on the development of the patient.
Enlargement or replacement of the first artificial eye for an infant, may be required in a year or less. This is mainly due to growth and color change, during the first two years of an infant’s life. It is often possible to enlarge your child’s current prosthesis, if only minor changes are required. This can defer the need for a completely new prosthetic eye, for at least 2 years.
In between the ages of 2-5, annual replacements are common, but again not always necessary. This is dependent upon the amount of tissue settlement in the eye socket, and growth of the child. At approximately age three, follow up visits to the ocularist can be reduced to every six months in some cases. In the age bracket of 6-12, replacement of the prosthetic is required even less frequently, due to the slow, steady change, and growth of children. However, the patient should still continue with follow-up visits every six months, so that the ocularists are able to see if any significant changes have occurred.
Pegging and Integrated Movement
At D. Danz & Sons, Inc. we have extensive experience in providing the peg placement procedure for Hydroxyapatite and Med-Por implants. These are porous implants that can receive a peg attachment that integrates with the prosthetic eye. This procedure greatly enhances the movement of your artificial eye.
Our ocularists are available to provide a complete evaluation and consultation, regarding the advantages and disadvantages of peg integration. Their experience includes every available peg attachment system along with our team approach, which will assure close communication with your ophthalmologist or oculo-plastic surgeon. This will provide you with the confidence and comfort you deserve to have, in allowing us to serve your prosthetic eye needs.
The Fabrication Process
Artificial eyes have been produced and worn since the times of ancient Egypt. Materials have ranged from precious metals and stones, to glass, to our modern plastics. Today, we use a common acrylic called Polymethylmethacrylate. It is lightweight, durable, simple to modify, and gives the lifelike appearance of a natural eye.
Typically, your prosthesis will be finished in three visits. The first visit consists of a consultation with your ocularist, the evaluation of your particular needs, and finally, an impression is taken of your eye socket in order to give us a detailed model of the specific size, shape, and conformity of your final prosthesis. Our impression is made from the highest-grade dental alginate. On your next visit, we will have a white acrylic pattern ready. With this pattern, we will modify the shape to achieve optimum symmetry, comfort, and movement, and then determine the direction of gaze.
While you are away, we will prepare your prosthesis for painting. We hand paint your iris, pupil, sclera and veins directly from your companion eye, while you are in the office.
When the painting is finished, a layer of clear acrylic is cured over the front surface, giving it a very natural appearance and depth. It is then polished and delivered for its final evaluation.
D. Danz & Sons, Inc. assists our patients in the billing of all major health insurances. All insurance requires pre-approval, which our staff is helpful in obtaining, with assistance from the patient and/or their referring doctor.