Know your Ocularist and their glorious hard work well, how they are able to give an eye for an eye... OCULARISTRY

• Ocularistry...

We can define Ocularistry by a glamorous sentence that,

Ocularistry is a divine art, gifted by the gracious god, towards the Prosthetic Rehabilitation of the facial or eye-lost (basically the part of eye) deficiency.       

Before

After

• Ocularist...

An Ocularist is who specialize in the fabrication and fitting an Ocular Prosthesis by the basis of science and art combination for the people who have lost an eye or eyes due to trauma or illness.

Mr. Siddhartha Banerjee
Director and consultant ocularist, Karunamayee Prostetic Eye Clinic,

2, P.C. Sorcar Sarani (Ekdalia Road), Kolkata- 700019, India.
Former head @ Ocular Prosthesis Service,LVPEI.
Former assisstant Ocularist @ L.V.Prasad Eye Institute,
Hyderabad.
Ph : 09641792026/ 08170838233
email : siddhartha.ocularist@gmail.com

Artificial eye / Ocular Prosthesis...

For the patient, the loss of an eye can be devastating. The prosthetic eye offers a good solution, as it helps the person be at ease and participate comfortably in social activities. The artificial eye looks like a natural eye-however, it is made of plastic and does not proviso vision. Yet, it plays an important role as it provides symmetry to the face, lending a normal appearance to the wearer.

At the ocular prosthesis clinic, we perform all procedure with expert know-how and, thereby, frequently avoid further surgery. We have vast experience in making Customized Ocular Prosthesis or artificial eyes for both adults and specially for children. An artificial eye replaces an absent natural eye following an Enucleation, Evisceration, or an Orbital Exenteration. We are prominently able to create a near-natural artificial eye using the latest devises.

The prosthetic eye made of Poly methyl methacrylate (PMMA) resin, an acrylic plastic used in dentures. We used the most advanced bio-materials to create extremely realistic ocular prosthesis. We craft and fabricate(hand paint) each prosthetic eye to match the patient's other eye as closely as possible.

Indication for fitting a Prosthetic eye...  

• Evisceration :When the contents of the eye ball are removed and the sclera (the white portion of an eye) is intact.
• Enucleation: When the entire eye is surgically removed.
• Exenteration: When the eyeball and other adjacent structures of the eye are removed.
• Anophthalmia: when one or both eyes are absent from birth.
• Microphthalmia: When the eyes are very samll due to a developmental disorder.
• Phthisis bulbi: When the eye is shrunken and non-functional due to severe ocular disease, inflammation or injury.

• The presentation of Ocularistry, as well as an Ocularist...

• So, let you know that what exactly we, Ocularist are treating with a patient in Ocularistry field.
• Ocularistry not a magic nor a surgery, but we are fitting an ocular prosthesis technically by the help of combination of both science and art. 
• An one eyed patient or the patient who has not two eyes also, can also live his/her life according to his/her lifespan, but they are used to come to an Ocularist not only for facial beautification but also for get back their confidence to live properly in their society. It is a great thing that, we, ocularists are doing that work to rehabilitate a patient.

Now, we are coming to discuss about this amazing matter...

A patient was suffering by a life threatening disease in right eye, choroidal melanoma,
cured by removed the eye through underwent a surgery, Enucliation, has came for right eye
artificial eye. 

• At first when a patient comes to make an artificial eye, then we are used to do a proper counseling of this patient that, what we are going to do with him/her and about the whole procedure, cause of patient should know that and may co-operate with us well, after that only we can give an exact cosmesis. The whole procedure is depends upon both doctor and patient's co-operation. 

• So proper counselling to a patient is a vital thing. At the time of counselling we have to say to patient some normal things like, the procedures which we will do, are fully painless and healthy, if the patient cooperate with us then prosthetic could make near to natural eye.

Proper counselling of a patient is necessary 

•  The whole procedure is divided into 4 types of techniques and takes time around 8 to 10 hours.
• These techniques are... 

a) Impression taking technique...

• Lets discuss about the base and important technique on which the whole procedures perfection is depending, that is Impression taking technique. In this technique usually we take a measurement of patient's eye socket by some tools and materials ie.: impression tray, calcium alginate etc. for a rough idea of a custom artificial eye which will made for the same patient, some images for the Impression taking technique has given bellow.

1) Impression tray selection according to the patient's socket.

2) Impression tray inserted into the socket.

3) Calcium-alginate solution injecting into the socket through
a 10 ml disposable syringe without needle. 

4) Solution usually takes 2 minutes to set. 

5) Impression or socket measurement is ready.

b) Wax modelling technique...

The next procedure after Impression taking technique is Wax modelling, briefly we use a wax-replica of prosthesis (which we get through converted that impression into the wax) for matching exact shape and fitting according to patient's sighted eye. We play with the wax-model and make exact shape according to another original eye. Some images of Wax-modelling has given bellow.

)

1)  Impression is converting into wax.

2) Impression has been converted into the wax already.

3) The wax model has made by exact shape and fitting according to
patient's  original eye

5) Patient with wax-model.

• Iris Paint...

After Wax modeling, we do the Iris paint, means we paint the iris-color on a black disc according to patient's iris color. After that we give a three dimensional look of that painted iris. Images has given bellow.

1) Iris painting.

2) Artificial iris color matching with the original iris.

3) 3D view of an Iris.

c) Mold casting technique...

• The third procedure is Mold casting, by which technique we make a mold of wax-model which already made through previous technique, after making the mold properly we fill some semisolid substance(made by acrylic-plastic dust and a type of catalyst) into the empty space of mold and polymerized it through a polymerization machine.
• After proper polymerization we get the plastic model of the wax. Some images of mold casting and plastic model has given bellow. 

1) The fine mold casting of the wax-model.

2) After open the mold.

3) That empty space has already made where we'll put the
plastic's semi-solid substance.

4) After polymerization the plastic model has made.

and finally...
d) Color matching technique...

• Now we do smooth and fresh of that plastic model by trimming and polishing, after that the plastic model is ready for color match.
• We put blood vessels on the white part of the plastic, after that we start the color matching according to patient's eye color. Images has given bellow.

1) Trimming the plastic model.

2) Close picture of trimming.

3) Blood vessels putting.

4) Color matching over a plastic model.

5) Color matching with the patient's original eye.

• After those lots of procedure, techniques, spend a lot of time, hard working we are able to give such a good cosmesis(near about 80% -90%) of patient's pretty face, which cosmesis is not easily noticeable by others, even the artificial eye movement will be 60% also.

The Customized Ocular Prosthesis or artificial eye,
ready to fit into patient's empty socket.

After fix an artificial eye

Before...

After...

• Artificial eye or Ocular prosthesis's care and maintenance...  

1. Always clean hands when handling your prosthesis.
2. Clean your prosthesis twice or thrice in a week is ideal. Use baby shampoo and normal drinking water and rinse thoroughly. You have to wash your prosthesis throughout the life.
3. Do not clean your prosthesis with hand sanitizer or alcohol (medical spirit), hot water, chilled water, as these chemical may damage the prosthesis and your eye socket.
4. An artificial eye should be replaced or changed approximately every five years.
5. Wear protective glass, when there is chances of injury to your sighted eye.
6. Apply a lubricant eye drop daily.
7. Visit to your Ocularist twice in a year or 6 moths alternatively for a general check up, it is mandatory.
   1. 1. 1.  

Thanks,

Siddhartha Banerjee, Bsc. Opt, FLVPEI,
Former Consultant Ocularsit, Ocular Prosthesis Clinic,
L. V. Prasad Eye Institute, Hyderabad.
Chief, Karunamayee Prosthetic Eye Clinic,

Contact : 09641792026/ 09088026592/ 08170838233
email: siddhartha.ocularist@gmail.com

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