Prosth Fitting 9.5

Question 1

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

Answer 1

ocular prosthesis

Question 2

types of prosthetic devices

Answer 2

prosthetic eye
prosthetic shell

Question 3

Ocular prostheses are:

Answer 3

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

Question 4

Prostheses are usually made of plastic because of its:

Answer 4

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

Question 5

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

Answer 5

prosthetic eye

Question 6

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

Answer 6

prosthetic eye

Question 7

Prosthec eyes may be made of:

Answer 7

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

Question 8

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

Answer 8

1. shrunken
2. blind
3. disfigured.

Question 9

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

Answer 9

haptic lenses

Question 10

An ocular prosthec device may be provided by an:

Answer 10

1. optometrist
2. ophthalmologist
3. ocularist.

Question 11

The fitting of a prosthetic device requires:

Answer 11

1. patience
2. innovation
3. artistic skills

Question 12

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

Answer 12

Evisceration

Question 13

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.

Answer 13

natural eye movements’

intraocular malignancy

sympathetic ophthalmia

Question 14

Two types of evisceration procedures exist:

Answer 14

1. evisceration with insertion of an intra-scleral implant
2. evisceration without implant insertion.

Question 15

• this procedure involves removal of the entire globe

Answer 15

enucleation

Question 16

Enucleation is indicated for the following condions:

Answer 16

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

Question 17

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

Answer 17

Simple enucleation

Question 18

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.

Answer 18

recti muscles

Question 19

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.

Answer 19

simple enucleation

Question 20

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

Answer 20

Enucleation with implant

Question 21

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

Answer 21

orbital structure

Question 22

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.

Answer 22

Tenon’s capsule

Question 23

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

Answer 23

Exenteration

Question 24

exenteration occurred due to:

Answer 24

1. severe trauma
2. malignancy

Question 25

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

Answer 25

Facial restorations socket impressions

Question 26

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

Answer 26

Spherical implants

Question 27

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.)

Answer 27

inert mesh

Question 28

types of implants

Answer 28

1. Polyethylene Beren's spheres 2. BioeyeTM Hydroxyapatite ocular implant

Question 29

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.

Answer 29

BioeyeTM Hydroxyapatite Ocular Implant

Question 30

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

Answer 30

Polyethylene Beren's spheres

Question 31

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

Answer 31

Conformers

Question 32

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

Answer 32

conformers

Question 33

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.

Answer 33

conformers

Question 34

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.

Answer 34

conformers

Question 35

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

Answer 35

conformers

Question 36

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

Answer 36

1. Surface deposits 2. Scratches 3. pits 4. roughness

Question 37

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

Answer 37

Trauma severe ocular disease possible metastasis of a carcinoma.

Question 38

The prosthetic fitting challenges include achieving:

Answer 38

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

Question 39

globe anomalies

Answer 39

 Scarring  Coloboma  Albinism

Question 40

Prostheses may be required as a result of

Answer 40

1. Trauma 2. Malignancy 3. Developmental anomalies 4. Degenerave condions

Question 41

Prostheses used when the natural eye remains

Answer 41

1. Thin prosthetic eye 2. Cosmetic shell

Question 42

Conformers:

Answer 42

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

Question 43

fitting methods

Answer 43

custom fitting stock fitting Variation of standard sets

Question 44

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

Answer 44

custom fitting

Question 45

Basic fitting goals

Answer 45

 optimum pupil diameter  Orthophoric appearance  Stability of fit

Question 46

fitting considerations on overall size

Answer 46

horizontal vertical exophthalmos enophthalmos

Question 47

Care and maintenance

Answer 47

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

Question 48

aftercare evaluation

Answer 48

Scratches, deposits refitting Replacement

Question 49

Indications for modifications

Answer 49

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

Question 50

Modificaon

Answer 50

1. Enlargement 2. Size reduction 3. Alignment

Question 51

Additional ocular features

Answer 51

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

Question 52

patient management

Answer 52

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

Question 53

Supplies and equipment

Answer 53

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

Question 54

inflammation or infection of eye socket is treated with the

Answer 54

prosthesis in situ