Ocular Prosthesis- Making a prosthetic lens
At Eye Excellence our resident optical consultant specialises in ocular prosthesis and so it is only fitting that we do a post dedicated to ocular lenses.
Ocular Prosthesis can be described as an artificial eye made to substitute the biological eye following enucleation, evisceration or orbital exenteration. The Ocular lens fits under the eyelids to cover an orbital implant or it is worn over a damaged eye. 
Making a Prosthetic
There are two types of prosthesis currently out on the market, A customised prosthesis, where the ocular lens is made for the patient, and a stock prosthetic. The obvious advantages of a personalised lens is improved comfort and fit. Stock lens most often appear unnatural due to their bulbous appearance and improper fit and poor shade matching.
With a personalised lens the iris position, shape, colour and size of the biological eye can be matched to improve symmetry. Better movement can be achieved by thinning the lens at the posterior end and the lens can be punctured to produce small holes which encourages natural tears. All together giving a natural appearance.
Step 1 :
Upon arrival to our practice patients are greeted by our front of house staff. With the aim of putting the patient at ease, our front of house staff usually offer them tea, coffee or an alternative beverage before proceeding to take their personal details and going through any paper work. Once this is complete the patient is then sent through to Kanti Fatania FBDO CL FBCLA for their consultation. Kanti initially speaks to the patient outlining the process and the steps involved. Alongside the patient, Kanti evaluates their current prosthetic. Highlighting what needs improvement.
Kanti proceeds to take an impression of the eye socket. Using a dental casting gel Kanti makes a mould of the eye socket. The patient is subsequently led to our photography suite where a DSLR camera is used to take a photograph of the patients functioning biological eye. The impression enables a customised fit. The patient’s volume and lid contours are duplicated. Thus resulting in a more natural looking and comfortable final product. This image is them magnified and viewed digitally. It can on some occasions be printed should this be necessary. Observations of any distinct colouring, veins or discolouration are noted in the patients file. The image will ultimately serve as a guide for the iris and scleral colour of the prosthetic lens.
Following this the pupil diameter is measured using a special ruler which accurately allows the measurement pupil diameter. These measurements are recorded alongside the patient’s notes.
The impression of the patient’s eye socket is duplicated within a cast stone. The cast is then packed with medical grade acrylic and cured. Once completely cured the borders of the acrylic are then rounded off and the shell surface is smoothed out. The patient is then called back to the practice and given the shell to try. During this fitting corneal prominence is checked and if necessary the front of the shell is reshaped to better fit the eyelid. The shape of the lids are also observed to ensure they mirror the functioning eye.
Once a comfortable fit is determined the iris is hand painted onto the shell. Great care is taken to mimic the patterns and pigments in the biological functioning eye. The image taken during the initial consultation is used as a reference throughout this process. The vein pattern is also matched, using tiny silk threads. Finally the sclera is accurately tinted to match the colours of the patients existing eye
The shell is then left to completely dry before a final layer of clear acrylic is applied. This seals in the veining and pigments, and seals out any dust. The final seal also serves to prevent the pigments in the sclera from fading. The shell is then reshaped and polished to remove scratches, reduce dullness and give a natural shine.
The prosthesis is then once again tried on by the patient. Details such as iris colour and position are position are evaluated. Further adjustments are made should they be needed. The end result is a lens that is comfortable and inconspicuous.
A personalised prosthesis produces the best cosmetic results. They better aid the patient when rehabilitating into normal life by dramatically improving comfort and self-confidence. The attention to detail whilst fabricating, results in a lens that mimics the appearance and colouring of the functional eye. The thin and light weight prosthetic is able to maintain its orientation whilst various eye movements are performed. All these factors combined help to ensure the most natural and life like appearance is maintained
If you or someone you know could benefit from the help of Mr Kanti Fatania FBDO CL FBCLA please do not hesitate to get in touch with us. We have an entire team of dedicated staff ready to serve you and answer your questions
Call today to schedule your free consultation on 02074874267