Prosthetic management of ocular defect: Esthetics for social acceptance

Abstract

It is quite usual for a person to have a natural eye removed as a result of a severe trauma; congenital abnormality; or disease such as an infection, a tumor or untreatable painful glaucoma. In such situations, the natural eye is removed by an acceptable medical procedure, for example, by enucleation or evisceration. It is also usual for a person to have a smaller than normal or phthisical eye that is blind. An ocular prosthesis is created to restore a more normal anatomical structure and the cosmetic defect created by these conditions in a person. The initial step in creating this prosthesis is the preparation of an impression of the ocular socket. From this impression, an ocular prosthesis is created that simulates a person's natural eye and is inserted into the ocular socket posterior to the lids and anterior to the orbital implant or phthisical globe. With such a procedure, a person's psychological trauma associated with the loss of the eye is reduced, and a more cosmetically acceptable appearance results from the use of these prostheses. Although implant eye prosthesis has a superior outcome, due to economic factors it may not be advisable in all patients. Therefore, a custom-made ocular prosthesis is an excellent alternative. Here, we present a case of a custom- made ocular acrylic prosthesis, which showed excellent fit, retention and esthetics. These prostheses usually comprise a scleral region with veins, an iris, a pupil and a clear corneal layer.