Ocular Prosthetics

Question 1

Which procedure scoops the goop?

removes inside of orbital contents but globe is intact

Answer 1

Evisceration

Question 2

Which procedure removes the globe but keeps the muscles

globe and all contents removes; EOMS intact

Answer 2

Enucleation

Question 3

Which procedure removes everything

no motility

Answer 3

Exenteration

removes glove, EOMs, surrounding tissue and bone

Question 4

What are causes of enucleation?

Answer 4

painful, blind eye; pthisis bulbi, trauma, endophthalmitis; retinoblastoma

Question 5

A scleral shell is used after which procedure?

Answer 5

enucleation

Question 6

Implants are used after which procedures?

Answer 6

evisceration and enucleation

Question 7

What are non-integrated implants made of?

think smooth

Answer 7

glass, acrylic, silicone

poor movement of implant

Question 8

What are integrated implants made of?

think porous

Answer 8

hydroxyapetite (coral-like); polyethylene; aluminum oxide

better movement of implant

fibrovascular attachment

Question 9

Why is tissue depth more important than material choice?

extrusion

Answer 9

too deep increases risk of infection

Question 10

What is Post-enucleation socket syndrome?

Answer 10

failure to replace enough volume; deep UL sulcus; ptosis, enophthalmos

backward rotation of prosthetic

Question 11

When is a conformer used?

place holder: prevents contraction of socket

Answer 11

evisceration and enucleation

prosthetic is fit 4-8 weeks after surgery

Question 12

An oculo-dermal prosthetic is fit after which procedure?

Answer 12

Exenteration

Question 13

Which type of prosthetic is an altered soft contact lens?

Answer 13

soft prosthetic

Question 14

How are soft prosthetics tinted?

Answer 14

in office, by computer or hand painted (custom)

Question 15

When soft prosthetics are used, a ________ step is needed

Answer 15

wash

Question 16

When are soft prosthetics used?

Answer 16

cosmesis, sports vision, photophobia, occlusion therapy, migraines

Question 17

What is the contact lens used for color deficiency?

Answer 17

X-Chrom

fit on non-dominent eye only

helps with color identification and matching and discernment of figures

Question 18

What type of lenses are used for sports performance?

Answer 18

Altius daily disposables

hydrogel; amber and grey-green

thought to improve sports performance

Question 19

Which type of tinted contacts are “stack” lenses?

Answer 19

Orion

Question 20

Which type of tinted contacts are available with or without black backing?

Answer 20

Nissel and Cantor

Question 21

Which prosthetic is <3mm thick and fits over the globe

removed nightly: helps with oxygen

Answer 21

scleral shell

patients still have globe or small socket; evisceration

Question 22

Which prosthetic is a “full” prosthetic, > 3 mm thick and has limited motility

may or may not have a peg to improve motility

if peg, then porous implant

Answer 22

Reform Prosthetic

removed no more than 1x per month

Question 23

What do we look for when evaluating the prosthetic on eye?

Answer 23

misalignment, color mismatch, sunken appearance

Question 24

What do we look for when evaluating the prosthetic off eye?

Answer 24

cracks, chips; deposits; crazing (must be replaced, causes discomfort)

Question 25

What removes calcium salts from a prosthetic?

Answer 25

GP solutions

Question 26

How often are prosthetics polished?

Answer 26

~6 months

Question 27

How often are prosthetics replaced?

Answer 27

~5-7 years

Question 28

What is the most serious complication of prosthetics?

Answer 28

implant infection