Clinical Ocular Prosthetics by Keith R. Pine, Brian H. Sloan, Robert J. Jacobs

By Keith R. Pine, Brian H. Sloan, Robert J. Jacobs

This is the 1st textbook to supply a accomplished account of ocular prosthetics and the proof used to underpin and aid this box of healthcare. It does so by way of bringing jointly info from ophthalmology, prosthetic eye and phone lens literature, and from specialists actively engaged in those fields.

The booklet describes the mental, anatomical and physiological facets of eye loss in addition to surgeries for removal the attention, sufferer overview, developing prosthetic eyes (including prosthetic and surgical strategies for facing socket complications), the socket’s reaction to prosthetic eyes, prosthetic eye upkeep and the heritage of prosthetic eyes.

Though basically meant for prosthetists, ophthalmologists, ophthalmic nurses, optometrists and scholars within the fields of ocular drugs, maxillofacial medication and anaplastology, the e-book additionally bargains an invaluable source for different medical examiners and kinfolk who take care of prosthetic eye sufferers, and for these sufferers looking a deeper figuring out of the problems affecting them than they could locate elsewhere.

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Sample text

6). International comparisons of the biosocial profile of prosthetic eye wearers have not been made, but some information can be found on related topics. For example, Chang et al. [7] described aetiologies and clinical characteristics of corneal opacities leading patients to seek cosmetic treatments at the Department of Ophthalmology at Seoul National University Hospital. They examined 401 patients with corneal opacities and reported characteristics of age and gender that were similar to the anophthalmic population in the New Zealand study.

Used to restore lost orbital volume Sulcus A groove or furrow Superior Overlying, above Superior sulcus The sulcus above the eye (upper eyelid sulcus) between the skin on the upper eyelid and the skin of the eyebrow Suppurate Fester, form pus Surfactant A substance that reduces the surface tension of water Sympathetic ophthalmia Inflammation in one eye caused by the immune system’s reaction to injury of the other eye Synergy An interaction that produces a whole that is better than the sum of its parts Synovial fluid Viscous fluid found in joints Tarso-conjunctiva The tarsus and its tightly adherent conjunctiva Tarsorrhaphy Suturing the eyelids together l Glossary Tarsus A plate of dense connective tissue that gives shape to the eyelids Tear break-up time test (TBUT) A measurement of the time it takes for the tear film to break up after blinking Tear ferning test A clinical test to measure the tear quality.

40 Fig. 41 Fig. 42 Fig. 43 Fig. 44 Fig. 45 Fig. 46 Fig. 47 Fig. 48 Fig. 49 Fig. 50 Fig. 51 Fig. 52 Fig. 53 Fig. 54 Fig. 55 xxix A posterior platform is added to the prosthesis. The platform is designed to prevent backward rotation of the prosthesis, to allow for a narrow lower edge to engage the inferior fornix and to reduce some of the bulk (and weight) of the prosthesis The conical anterior surface supports and wedges the eyelids apart while minimising the overall bulk of the prosthesis The four rectus muscles are identified and the intra-conal space is defined The largest spherical implant that can comfortably be accommodated by the socket is chosen The implant is placed in the intra-conal space and the rectus muscles sutured to it Any available remnants of Tenon’s capsule are closed in front of the implant, and then the conjunctiva is closed without tension A temporary tarsorrhaphy is placed to control post-operative conjunctival swelling Subperiosteal implants are designed to displace the orbital tissues upwards and forwards restoring lost orbital volume and filling out a deep upper eyelid sulcus Extra bulk added anterior to the superior edge may help correct upper eyelid sulcus deformity and restore the upper eyelid crease A second ridge in front of the inferior edge, in conjunction with thinning of the lower edge from the back, sets the prosthesis upright and counters the potential backward displacement of the bulkier upper edge The prosthetic eye has improved (reduced) this patient’s right lower eyelid ectropion The inward rotation of the eyelashes that is part of upper and lower eyelid entropion has caused an accumulation of mucous on the prosthesis The convex curvature of the anterior surface is made concave behind the entropic eyelids This configuration attempts to resolve upper eyelid ptosis by filling the superior fornix and lifting the levator aponeurosis muscle This patient’s ptosis on the medial side of the eyelid causes a marked contour abnormality of the upper lid, drawing attention to the prosthetic eye A diagonal ridge is added in the location shown by the dotted line A ptosis shelf can be seen on this prosthetic eye.

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