custom prosthetic eyes - waeps · ocular prosthesis. a helaing art patient results care &...
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EYE LO
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Prosthetic EyesTodd Cranmore BCO/BADO
Licensed Ocularist
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a personalized approach to prosthetic eyes
Realities of Eye Loss‣Anxiety‣Depression‣ Fear of Blindness‣ Loss of Depth
Perception‣ Loss of 15-20%
Peripheral Vision‣ Life goes on...
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a personalized approach to prosthetic eyes
Eye Loss Conditions leading to a scleral shell
‣Phthsical Eye‣Accident or Injury‣Retinal Detachment‣Glaucoma‣Corneal Dystrophy‣ Infection‣Evisceration
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Evisceration‣Removal of the contents of
the globe, leaving the sclera and extraocular muscles intact‣ Indications:‣ Endophthalmitis
‣ Improve cosmesis in a blind eye
‣An ocular implant is typically placed during this procedure‣A scleral shell can be fit 6-8
weeks post-op
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Eye Loss Conditions leading to an artificial eye
‣Trauma‣Blind, Painful Eye‣Ruptured Globe‣Tumors / Ocular
Melanoma‣Diabetic Retinopathy‣Endophthalmitis‣ Infection‣Enucleation
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Enucleation‣ Removal of the eye from the
orbit, preserving all other orbital structures‣ Indications:‣ Endophthalmitis‣ Blind Painful Eye‣ Malignant Intraocular Tumors‣ Ocular Trauma‣ Degenerative Phthisis‣ Congenital Anophthalmia‣ Severe Microphthalmia‣ An ocular implant is typically placed during the procedure‣ An artificial eye can be fit
6-8 weeks post-op
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Ocular Implants‣ Solid Sphere‣ Silicone‣ Lucite‣Porous Sphere‣ Hydroxyapatite (H-A, Coral, Bio-Eye™)‣ Porous Polyethylene (Medpore™, Porex™)‣ Aluminum Oxide (Alumina™)‣Dermis Fat Graft
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‣ First visit 1-2 weeks post-op‣ Meet with patient, explain process, ease anxiety‣ Examine socket, fit custom conformer
‣Every 2-3 weeks return for conformer check‣ Monitor healing‣ Change conformer if edema has reduced
‣After 6-8 weeks post-op‣ Begin prosthesis when edema reduced‣ Takes 3-4 appointments to complete prosthesis
Ideal ScheduleEY
E LOSS
Eye Loss in Children‣ Trauma‣ Retinoblastoma‣ Persistent Hyperplastic
Primary Vitreous (PHPV)‣ Retinopathy of Prematurity
(ROP)‣ Coloboma‣ Coat’s Disease‣ Microphthalmia‣ Anophthalmia
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‣ First visit 1-2 weeks post-op‣ Meet with patient, explain process, ease anxiety‣ Examine socket, fit custom conformer
‣Every 2-3 weeks return for conformer check‣ Monitor healing‣ Change conformer if edema has reduced
‣After 6-8 weeks post-op‣ Begin prosthesis when edema reduced‣ Takes 3-4 appointments to complete prosthesis
Ideal Schedule
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Iris Matching‣ Iris is painted with
powder pigments to match the fellow eye‣Patient is used as
model for accurate matching‣Pattern and color are
accurately painted layer by layer
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Processing Iris Button‣ Iris is capped with
clear acrylic, then cut back on a radial lathe‣ Iris is capped again
with white acrylic‣ Iris is cut back to
reveal a even, realistic blend
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Socket Impression‣ Silicone is injected
through conformer into socket‣ Impression sets in
about 1.5 minutes‣ Important for the
comfort and movement of the ocular prosthesis
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Processing the Blank‣ Impression is set in
cast with castone‣Acrylic dough is
pressed into cast‣Acrylic is processed
with pressure and heat in polymerization unit‣Blank in rough form‣Blank is cleaned up,
shaped and polished
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Fitting the Blank‣Adjustments are made
to equalize lid opening and anterior shape‣ Iris position is marked‣Waxed fitting iris
ensures proper placement and plane
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Attaching the Iris‣ Flat plane with
position marks‣ Iris attached to blank
with acrylic dough‣Blank with attached
iris ready for veining
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Veining and Scleral Tint‣The silk thread is
frayed & set into a layer of acrylic on the prosthesis‣ Sclera is reproduced
using transparencies of acrylic pigment‣Veining is carefully
compared to fellow eye for accuracy
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Final Capping‣Veined prosthesis air
dries, then is capped with clear acrylic‣ Surface is shaped with
grinding tools‣Polished with pumice‣ Finely polished with
polishing compound‣Completed prosthesis
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Final Fitting‣Prosthesis is fit and
adjustments are made to equalize eyelid opening and anterior shape‣Overall cosmetic
appearance, lid function and movement are evaluated
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‣ Fit over phthsical eye‣Up to full-sized globe‣Alternative to colored
contact‣ Sometimes replaces
need for enucleation‣Patient can wear full-
time‣Excellent movement
Scleral ShellsO
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Follow-up Schedule‣Return after 2 months‣ Any adjustments are made
for comfort, fit and/or appearance
‣Return every 6 months‣ Polish and resurface
prosthesis‣ Check fit and conjunctival
tissue
‣Replace prosthesis every 5 years
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‣ Fit over phthsical eye‣Up to full-sized globe‣Alternative to colored
contact‣ Sometimes replaces
need for enucleation‣Patient can wear full-
time‣Excellent movement
Scleral Shells
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Scleral Shells
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Scleral Shells
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Scleral Shells
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Scleral Shells
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‣Ocular Prosthetics can easily be removed and replaced.‣ They are held in place by
the lower and upper eyelids and interior fit.‣ Most patients wear their
prosthesis full time, removing only occasionally to clean.‣Wearing full time is ideal.
Prosthetic Handling
a personalized approach to prosthetic eyes
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‣Ocular Prosthetics can easily be removed and replaced.‣ They are held in place by
the lower and upper eyelids and interior fit.‣ Most patients wear their
prosthesis full time, removing only occasionally to clean.‣Wearing full time is ideal.
Prosthetic Handling
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Prosthetic Handling‣Always use clean hands‣Check your surroundings
to make sure the prosthesis won't be damaged or lost if it is accidentally dropped‣Do not clean the
prosthesis with any solvents, tooth paste, hand sanitizer, or alcohol, as these chemicals may damage the prosthesis and socket
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Removing a Prosthesis
1) Pull down the lower eyelid with index finger, look up and slide finger towards the ear.
2) Allow the prosthesis to slide out over the lower lid. Gently remove prosthesis.
1) Open eyelids, apply suction cup to prosthesis and squeeze handle. When attached, relax squeeze, holding handle lightly.
2) Pull down lower with finger. Tilt the prosthesis up and out, over the lower lid. Squeeze suction cup handle to release.
WITH FINGERS:
WITH SUCTION CUP:
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Cleaning a Prosthesis1) Wash hands with soap
and warm water2) Use warm water to
rinse and softly scrub the prosthesis with your fingers
3) Only use soap when necessary - a mild soap like baby shampoo and rinse thoroughly
4) Dry with a soft tissue, polishing very lightly in a circular motion
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Inserting a Prosthesis
1) Lift upper lid with index finger to create an opening. Gently slide top edge of prosthesis under upper lid.
2) Release upper lid once prosthesis is in. Pull down lower lid and blink until prosthesis sets into position.
1) Attach suction cup to prosthesis. Lift upper lid and slide top edge of prosthesis under upper lid.
2) Release upper lid and pull down lower lid to seat prosthesis. Release suction cup. Blink eyelids.
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WITH SUCTION CUP:
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Things to Look For‣Check the prosthesis
for scratches and built-up protein‣Refer patient to their
ocularist if longer than 1 year since last polish‣Check the socket for
irritation, excess mucosal drainage and tissue complications
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Lubricants‣ Artificial eye wearers may
occasionally experience dryness, irritation, and difficulty blinking‣ Adverse weather, dust, wind and
air-conditioning tend to evaporate moisture from the front of the prosthesis‣ Silicone lubricants can be applied as
needed, typically morning and night - swipe on with finger‣Water-based eye drops can also be
applied as needed, typically every 2-3 hours
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Patient ResultsC
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Lubricants‣ Artificial eye wearers may
occasionally experience dryness, irritation, and difficulty blinking‣ Adverse weather, dust, wind and
air-conditioning tend to evaporate moisture from the front of the prosthesis‣ Silicone lubricants can be applied as
needed, typically morning and night - swipe on with finger‣Water-based eye drops can also be
applied as needed, typically every 2-3 hours
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Patient Results
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Patient Results
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a personalized approach to prosthetic eyes
Blake
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a personalized approach to prosthetic eyes
Restoration
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a personalized approach to prosthetic eyes
Restoration
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UThank You!
12911 120th Ave NE, Suite C-10Kirkland, WA 98034
425.823.1861 [email protected] 888.257.0770
Todd Cranmore BCO/BADOLicensed Ocularist
www.ericksonlabs.com