Prosthetic Rehabilitation of a Patient with an Ocular Defect with Custom-made Ocular Prosthesis: A Case Report

Case Report

Phys Med Rehabil Int. 2016; 3(4): 1093.

Prosthetic Rehabilitation of a Patient with an Ocular Defect with Custom-made Ocular Prosthesis: A Case Report

Bhochhibhoya A¹*, Mathema S² and Maskey B²

¹Department of Prosthodontics and Maxillofacial Prosthetics, Nepal Medical College, Nepal

²Department of Prosthodontics and Maxillofacial Prosthetics, People’s Dental College and Hospital, Nepal

*Corresponding author: Bhochhibhoya A, Department of Prosthodontics and Maxillofacial Prosthetics, Nepal Medical College, Attarkhel, Kathmandu, Nepal

Received: July 05, 2016; Accepted: July 19, 2016; Published: July 22, 2016


The disfigurement resulting from an ocular defect causes significant impact on the self-image and personality of an individual. Patients with such maxillofacial deficiencies often face crippling problems associated with functional disability and social reactions. Thus, rehabilitation of ocular defects is essential for physical and psychological wellbeing of the patient and to improve their social acceptance. The objective of prosthetic rehabilitation is to mimic natural esthetics so as to provide a cosmetically acceptable prosthesis. A custom ocular prosthesis is a noble alternative in situations where surgical reconstruction or the use of implants is precluded. This article outlines a simplistic procedure for construction of custom-made ocular prostheses in a patient with ocular defect following traumatic injury.

Keywords: Ocular; Custom-made; Maxillofacial; Prosthetic rehabilitation


The unfortunate loss of an eye is generally associated with a congenital defect, trauma, tumor, sympathetic ophthalmia or the need for histological investigations [1]. Ocular trauma often results in phthisis bulbi; a small, shrunken, non-functional eye [2]. Surgical procedure for these conditions may necessitate an orbital evisceration, enucleation or exenteration. Evisceration involves removal of contents of the globe, leaving the sclera intact. Enucleation is a more aggressive procedure in which the entire eyeball is severed from the muscles and optic nerve. Exenteration, the most radical, involves removal of the contents of the orbit [3].

The mutilation caused by loss of an eye has a crippling effect on the person’s personality which causes significant physical and emotional problems [2-5]. Most patients experience significant stress, primarily due to the functional disability and to public reactions to the disfigurement [6]. Prosthetic rehabilitation of such ocular defect with a cosmetically acceptable prosthesis that reproduces the color, form and orientation of iris is required to endorse psychological comfort to the patient and to make them socially acceptable [7]. Various methods of rehabilitating such ocular defects include either ready-made or custom-made ocular prosthesis [8-11]. Plethora of fabrication techniques forcustom made ocular prosthesisexistswhich permits variations during its construction.

The art of making artificial eyes has been known tomankind from the days of the early Egyptianswell before 3000 BC. Ambroise Parre is considered the pioneer of modern artificial eye. He made use of both glass and porcelain eye. Not until World War II, andthe development of refined plastics has there beenthe option for a satisfactory aesthetic ocular prosthesis [6,12,13].

Ready-made stock eye prosthesis comes in standard sizes, shapes, and colors and they require no special skills or materials for fabrication. They are relatively inexpensive and less time consuming. However, custom made ocular prosthesis have several advantages including improved adaptation to underlying tissues, better mobility of the prosthesis, even distribution of pressure due to equal movement thereby reducing the incidence of ulceration, improved fit, comfort and enhanced esthetics. However, a custom made prosthesis is more expensive than a stock prosthesis, and multiple steps are required for its fabrication [6,14-16].

Case Presentation

A thirty-five year old male was referred to the Department of Prosthodontics and Maxillofacial Prosthetics, People’s Dental College and Hospital for prosthetic rehabilitation of an ocular defect. The patient gave the history of trauma of right eye three year back and consequently the eye had shrunken.

Clinical examination revealed enophthalmic and phthisical globe with corneal opacity (Figure 1). The intraocular tissue bed was healthy and the depth between the upper and lower fornices was adequate. The posterior wall of the defect showed synchronous movements. The conjunctival lining and palpebral fissure did not exhibit any abnormality. Fabrication of custom-made ocular prosthesis was planned for the patient since it gives better result than ready-made stock eye prosthesis.