What is an ocular prosthesis?
Plastic ocular prostheses, more precisely polymethyl methacrylate (PMMA - the same material used in dentistry), were created during the Second World War, in 1938 in the USA to fill the gap in raw material which was cryolite (for glass eyes).
Ocular prostheses are part of the family of large devices. Their purpose is to "promote, as quickly as possible, the social reintegration of subjects with a malformation or mutilation of the eyeball, or those whose permanent loss of vision (with preservation of the eyeball) is accompanied by a reduction in ocular volume or an unsightly modification of the anterior segment of the eye. Fitting with an ocular prosthesis is a reconstructive device for aesthetic and not optical purposes" (decree of 16/10/07 – Ministry of Health, Youth and Sports defining the objectives of ocular prosthetics).
My ocular prostheses are always custom-made from an alginate impression. This allows the prosthesis to be adapted to the nearest millimeter in the eye socket or over the eyeball. They allow excellent patient tolerance due to their lightness (2 to 4g) and thickness (>1mm). The material is very resistant to shocks unlike glass, but also to tears (containing sodium chloride). A cast is made of this impression to create the provisional shape of white resin (1st layer). It will represent the sclera of the eye on which the iris and scleral chromatic characteristics will be reproduced. A second, transparent layer will protect the entire external surface of the prosthesis to prevent the tissues from coming into contact with the elements (pigments, vascularization) that reproduce the scleral characteristics.
Ocular prosthesis fitting promotes orbital wall reconstruction and orbital growth in children. Management must be immediate to avoid the risk of facial and skull asymmetry in general.
Ocular prostheses after mutilating surgery (enucleation/evisceration)
Temporary ocular prosthesis, tolerance test :
This is a transparent ocular prosthesis, without iris or vascularization, which will allow the patient and the ocularist to check its tolerance. It can be requested in case of any pain in the ocular cavity or for other reasons.
The provisional with impression taking :
This is a temporary cosmetic device for preparing the cavity before definitive fitting, after evisceration or enucleation. This step allows the tolerance of the prosthesis to be checked and the mutilated socket to heal. Try-out for 2 to 3 months.
The final :
Permanent cosmetic device after mutilating surgery about 3 to 4 months after surgery.
Changes and tracking
A "check-up" appointment will be given to the patient 3 months after receiving their final prosthesis in order to check its tolerance and to make any possible modifications (reduce, enlarge, iris, etc.). The service will be free.
Beyond 3 months, any changes will be charged.
Covering ocular prostheses (on blind or partially sighted eyeballs)
This is a scleral-supported ocular prosthesis with a clearance at the cornea level. The thickness will depend on the more or less marked atrophy of the eyeball.
The temporary prosthesis, coverage test, tolerance test :
The prosthesis will be made of transparent resin and will allow its tolerance to the eyeball to be checked. It will always be made before the provisional and definitive device.
The custom-made temporary covering ocular prosthesis :
This is the temporary device for preparing the definitive prosthesis.
The definitive ocular covering prosthesis with impression taking
Renewal of the ocular prosthesis
The renewal :
- No annual limitation for children under 10 years old.
- Every two years from 10 years to 20 years old.
- Every 5 years after 20 years old.
Early renewal :
The renewal of the ocular prosthesis can be linked to a biometric modification with or without taking a new impression.
So-called "special" prostheses
For partially or sighted eyeballs
It is possible to make a custom-made cosmetic ocular prosthesis (personalized iris and sclera) integrating a transparent pupil in order to keep vision intact.
For children
Following a birth deformity ( microphthalmia, anophthalmia or other), it is very important to adapt a conformer to the child. It promotes the reconstruction of the orbital walls, orbital and eyelid growth in children. Management must be immediate to avoid the risk of asymmetry of the face and skull in general. The placement of a conformer can vary between every 2 weeks to every month, 2 months, 3 months etc. depending on the severity.
Customizable ocular prostheses
It is entirely possible to make a custom ocular prosthesis for you without having to follow chromatic standards. You want a blue iris with a red pupil, no worries!
In addition, for young and old, I always indicate the top of the prosthesis with a marking whether it is a number or a crocodile head.
Repolishing
Repolishing of your ocular prosthesis is granted every 6 months or at the request of the prescribing doctor. This step makes it possible to monitor eye health, the condition of the cavity and the implant as well as to check the tolerance of the prosthesis. Monitoring the patient is essential because this can help prevent any abnormalities.
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7 zone artisanale du Muelhbach
68150 Ribeauvillé
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