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Ocular Prosthesis > Prosth Fitting 9.5 > Flashcards

Prosth Fitting 9.5 Flashcards

1
Q

is a non-optical device designed to improve the cosmesis of an individual who has had their eye removed or disfigured.

A

ocular prosthesis

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2
Q

types of prosthetic devices

A

prosthetic eye
prosthetic shell

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3
Q

Ocular prostheses are:

A
  1. molded
  2. painted (decorated to emulate the fellow eye)
  3. polished to create a realistic appearance.
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4
Q

Prostheses are usually made of plastic because of its:

A
  1. ease of fabrication
  2. good biocompability and, should the prosthesis become scratched or deposited, its capacity to be re-polished.
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5
Q

is used after the removal of the whole eye and is designed
to restore the natural appearance of the orbit and surrounding issues.

A

prosthetic eye

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6
Q

is typically fitted over an ocular implant that occupies the
place of the removed eye.

A

prosthetic eye

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7
Q

Prosthec eyes may be made of:

A
  1. blown glass or an
  2. acrylic (a plastic such as PMMA polymethyl metacrylate).
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8
Q

A shell is thinner and lighter than a prosthetic eye and typically, is fitted over
an exisng globe which may be:

A
  1. shrunken
  2. blind
  3. disfigured.
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9
Q

The fitting of prosthetic shells incorporating a vision correction is similar to the fitting of

A

haptic lenses

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10
Q

An ocular prosthec device may be provided by an:

A
  1. optometrist
  2. ophthalmologist
  3. ocularist.
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11
Q

The fitting of a prosthetic device requires:

A
  1. patience
  2. innovation
  3. artistic skills
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12
Q

removal of the global contents with retention of the scleral wall, muscles and cornea.

A

Evisceration

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13
Q

The advantage of keeping the ocular muscles intact is retention of ‘_____’ with the prosthetic shell in place. This conservative form of surgery is not appropriate in cases of ______ or when the
chance of_________ is high.

A

natural eye movements’

intraocular malignancy

sympathetic ophthalmia

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14
Q

Two types of evisceration procedures exist:

A
  1. evisceration with insertion of an intra-scleral implant
  2. evisceration without implant insertion.
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15
Q
  • this procedure involves removal of the entire globe
A

enucleation

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16
Q

Enucleation is indicated for the following condions:

A
  1. intraocular malignancy
  2. penetrating ocular injury which may cause sympathec ophthalmia
  3. painful, blind eye
  4. disfigured, painless, blind eye.
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17
Q

it is when the eyeball is removed but no implant is used

A

Simple enucleation

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18
Q

in simple enucleation, The_____ are sutured together to form a ‘stump’ that will assist in
prosthesis mobility. A sunken appearance may eventually manifest due to the lack of a space-occupying material.

A

recti muscles

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19
Q

This is not the procedure of choice since it results in a large socket for which the prosthesis must be large and thick (and therefore heavy). Usually, the prosthesis exhibits little movement.

A

simple enucleation

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20
Q

this is the most common operation. The globe is removed and an implant inserted to replace the space previously occupied by the eye.

A

Enucleation with implant

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21
Q

The implant maintains the_____ and gives support to an overlying prosthec eye/shell

A

orbital structure

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22
Q

The implant is placed in____ with the conjunctiva sutured together in front of the implant. The extraocular muscles remain associated with ____ and allow for movement of the implant in a manner similar to that of the natural eye.

A

Tenon’s capsule

23
Q

this procedure is the most radical. It involves removal of the entire orbital contents

A

Exenteration

24
Q

exenteration occurred due to:

A
  1. severe trauma
  2. malignancy
25
Q

_____ and ______ may be necessary to create some degree of facial symmetry.

A

Facial restorations
socket impressions

26
Q

made of plastic, glass or hydroxyapatite (similar to bone), which are placed within Tenon’s capsule and conjunctiva

A

Spherical implants

27
Q

A variety of implants in the shape of a modified hemisphere with a flat or rounded top. The top is covered with an_____ (stainless steel or TeflonTM to which extra-ocular muscles are sutured.)

A

inert mesh

28
Q

types of implants

A
  1. Polyethylene Beren’s spheres
  2. BioeyeTM Hydroxyapatite ocular implant
29
Q

made of bone-like porous material derived from ocean coral. This implant allows tissue and blood
vessel invasion which stabilizes the implant and encourages consistent positioning within the orbit. The latter also allows for relatively normal ‘eye movement’ of the implant and overlying prosthetic eye/shell.

A

BioeyeTM Hydroxyapatite Ocular Implant

30
Q

clear, non-water-absorbent spheres of 12 to 20mm diameter, used for implantation after evisceration or
enucleation

A

Polyethylene Beren’s spheres

31
Q

: are clear, plastic, oval-shaped concave discs placed in the socket over the implant during the post-operative phase of treatment.

A

Conformers

32
Q

They are inserted to prevent apposition of the sutures to the lids and to prevent irritation.

A

conformers

33
Q

are transparent. This allows healing of the tissues to be monitored, and scar tissue formation between the back of the lid and the conjunctival tissue over the implant to be curtailed.

A

conformers

34
Q

are also used to enlarge a socket in a patient who has gone without a prosthesis for a long period of time, with subsequent shrinking of the socket. This enlargement is managed by using progressively
larger shapes.

A

conformers

35
Q

form a pocket for the prosthesis, and hold the implant well back in the socket.

A

conformers

36
Q

cause irritation, which can result in infection of the socket:

A
  1. Surface deposits
  2. Scratches
  3. pits
  4. roughness
37
Q

Prosthetic eye/shells are commonly fitted to patients whose eyes
are surgically removed secondary to

A

Trauma
severe ocular disease
possible metastasis of a carcinoma.

38
Q

The prosthetic fitting challenges include achieving:

A

good comfort
cosmesis (matching colour and appearance)
alignment, including when changing the direcon of gaze.

39
Q

globe anomalies

A

 Scarring
 Coloboma
 Albinism

40
Q

Prostheses may be required as a result of

A
  1. Trauma
  2. Malignancy
  3. Developmental anomalies
  4. Degenerave condions
41
Q

Prostheses used when the natural eye remains

A
  1. Thin prosthetic eye
  2. Cosmetic shell
42
Q

Conformers:

A

Aid in healing
Help enlarge the eye socket
Variety of sizes available

43
Q

fitting methods

A

custom fitting
stock fitting
Variation of standard sets

44
Q

Well-fied prosthesis
Uses impression molding
More precise copy of the normal eye is possible

A

custom fitting

45
Q

Basic fitting goals

A

 optimum pupil diameter
 Orthophoric appearance
 Stability of fit

46
Q

fitting considerations on overall size

A

horizontal
vertical
exophthalmos
enophthalmos

47
Q

Care and maintenance

A

insetion and removal
Frequency of removal
Cleaning the prosthec eye/ shell

48
Q

aftercare evaluation

A

Scratches, deposits
refitting
Replacement

49
Q

Indications for modifications

A

 Prosthesis has been outgrown
 Socket shrinkage
 Orbital or lid changes
 Changes to the normal eye

50
Q

Modificaon

A
  1. Enlargement
  2. Size reduction
  3. Alignment
51
Q

Additional ocular features

A

 Pterygium
 Arcus senilis
 Iris freckles
 Ptosis crutch (ledge)
 artificial skin or cheek

52
Q

patient management

A

 History
 Test functional
 Inspection of orbit
 Cleaning and polishing of prothesis

53
Q

Supplies and equipment

A

 CL modificaon unit
 Motorized spindle (at least 1000 rpm)
 Dental wax
 Alcohol lamp
 Dental burrs
 Sandpaper
 Dental tools

54
Q

inflammation or infection of eye socket is treated with the

A

prosthesis in situ

Ocular Prosthesis (3 decks)

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