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Size Eye
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How I can find out the size of my eye?
I found some really cool special effects contacts online, but when I ask them I can not because I have no idea what size to get and not expensive to order the wrong size …. so I know they want to "flat" because I do not need glass, but my friend told me I had to go to an eye doctor to find out and I have no money to do that so … What I can do?.
The only way to know your corneal curvature (base curve) is a tool we have called a keratometer. But the measurement is only an assumption, which can operate or not. Sorry, but contacts are not toys, not one size either.
Make and shape of the eyes – Prosthetics Occlurar
* MANUFACTURE OF EYE PROSTHESIS
When the surgical site has healed While manufacturing and dimensionally stable, an ocular prosthesis can begin. Before beginning a detailed examination of the enucleated making should be made to ensure proper healing and the absence of infection. The location of the implant, the movement of the tissue bed, and the size and scope of the taking should be noted.
Impressions:
An impression of the socket can be irreversible hydrocolloid. An impression tray can be made from hard base wax by heating on flame and its adaptation to the contour of the area around the eye. A wax handle is attached to the aid of manipulation. The piece of tissue was obtained with a hot spatula to allow retention for the media. The patient sits erect, asked to look at a distant location and instructed to keep their eyes on an easy position with open eyes, while the printing is done. This procedure will ensure that the back of the enucleated socket and rectus muscles will be in the same position Eye on the Left.
Irreversible hydrocolloid is mixed with a measure of additional means of heating water, providing a smooth mixture, runny be established quickly. The media is placed in a large syringe. The enlargement of the opening of the tip of the syringe to facilitate the expression of the material print. With the patient's eyelids open, irreversible hydrocolloid mixture is injected into the socket, taking care not to fill out the plug without trapping small airbags. The lids are then released and some print materials is expressed in the eyelids. The tray, which has been coated with the media, is placed over the eyes and let it set. When activated, the material in the socket and eyelids can be removed as one piece. The patient is instructed to open the eye as widely as possible, and the impression is removed slowly. Attention because they do not tear the impression tray in the thin section represents the opening of cover. Before pouring the plaster, this section of the print can be enhanced by placing a straight pin through it in the back. Printing is inspected and verified the taking of any residual irreversible hydrocolloid.
Formulation of the model:
The impression is poured in two sections. A picture is formed around the tray with 3-inch tape. The first half of the cast is poured with a mix of stone with "water mud" to accelerate time setting. This procedure will prevent excessive water loss of printing. The mixture is vibrated to the print boxed up and around the widest part of socket printing. The print is placed in a humidor, while stone sets. At least two slots are cut into the surface of the first extraction with a strawberry large, hard rubber round. The stone is then lubricated with a separating medium and the second half of the print is discharged and returned to the humidor.
Manufacturing of the sclera:
After the stone has set, the mold can be separated by removing the wax tray and print media. With using a laboratory knife mold opening is enlarged to allow the melted wax is poured into it without having to freeze the wax before the mold is full. Soak in water mold warm for several minutes and remove excess wax will allow water to flow and fill the mold without adhering to the stone.
After the wax has cooled, the mold is opened and the wax pattern is recovered. The wax layer represents the opening of the cap is cut, the anterior surface of the pattern is outlined in a soft hemispheriod. The posterior surface reflects the topography of the tissue bed of the eye socket. Close adaptation of the posterior surface tissues to bed movement occurs of the ocular prosthesis in harmony with the natural eye. Close adaptation also reduces the accumulation of fluid behind the prosthesis that may cause irritation and promote bacterial growth.
The wax pattern is now on trial in the eye socket and lid edges are evaluated. To insert the prosthesis in wax, eyelid and rises above the upper edge of the prosthesis, the upper lid is lifted and the upper edge of the prosthesis is placed above and below the lid. Then, while drawing the lower lid down and the bottom edge of the prosthesis is seated. The wax pattern should be comfortable for the patient, but may cause mild irritation and tearing. The wax does not move as freely as the finished denture acrylic resin. The contour of the eyes and the openings in the lid are checked from different angles.
Where appropriate contours have developed the wax pattern is ready to be invested. Or a flask or a flask of crown and bridge can be used. orthodontic white stone is to prevent contamination of the sclera white or clear acrylic resin with yellow pigments dental stones. After filling the lower half of the flask with stone, some stone mixture is vibrated to the posterior surface of the wax pattern. Gently the wax pattern is placed in the top of the stone in the flask, taking care not to trap air. After the stone has set, the exposed stone is lubricated with a separating medium and the upper half of the bottle is full. When the stone has set, the bottle can be separated gently pry apart. It is not necessary boilout. The wax pattern is removed from the mold and the mold washed with soap and water to remove residual medium separation. A substitute paper layer is applied and the mold is ready to be packaged by compression method.
The material used in packaging scleral acrylic resin mold is white. * Commercially available or can be made by combining 1.5gm of zinc oxide powder with transparent acrylic resin 100gm. When processing the resin at 150 ° F for 9 hours at 212 ° F for two hours, the possibility of porosity is reduced.
The sclera acrylic resin is recovered from the flask and the flash removed with rotary instruments and polishing with wet pumice flour. With a wet rag wheel at low speed to avoid burning the acrylic resin. The sclera should be taken to a high gloss and wash with soap and water. The sclera resin acrylic is inserted and the contours of the hole in the lid and checked again. necessary adjustments are made at this time. If any grinding is carried out, the sclera must be polished before it can be returned to the hearing.
Iris location. The location of the iris is determined with the sclera in place and the patient standing in a relaxed position. Again the patient to look at a distant point. Compared with the natural eye, the center of the pupil of the prosthesis located and marked with a pointed applicator stick dipped in waterproof ink. The sclera is then removed. By placing the point of the compass of an architect in student center, a circle is drawn the same diameter as the natural iris. A waterproof ink to the printing of this circle. The size and location of the iris must match his remaining eye. This is easily verifiable by sight and by measuring with a millimeter rule to the inner edge and the inner edge of the blade as points reference. Another factor to consider at this point is the location of the iris in relation to the opening of the lid. Usually, the upper eyelid covers a portion of the middle top of the iris, while the bottom edge of the iris lies at or slightly above the lower eyelid.
The sclera is then reinvested in the same way the wax pattern. Reinvestment facilitates the handling in the sclera must be cleared for the incorporation of the iris. The anterior surface is also reduced to tinting of the sclera. The sclera removed material for these purposes are easily replaced with transparent acrylic resin.
Before the reinvestment of sclera, a piece of wax casting 28 gauge is placed on the circle representing the iris. A hot wax spatula used to remove excess wax outside the circle and the same time, to seal the wax to the sclera. When jars, wax will leave a depression in the stone jar in the position of iris. This depression deepened about 2 mm in the center and then to the sharp edges to form a concavity smooth and rounded. This concavity produce the prominence of the cornea in the finished denture. This area can be molded to capture highlights of the reflected light corresponds to the natural eye and produce a more realistic appearance.
The following procedure is the cut "for putting the painting of the iris. A diamond disc mounted stone with a square edge out this task smoothly and ease. Acrylic resin is removed to a depth of 3-5 mm, depending on the thickness of the sclera. An inverted cone bur carbide flattening the floor of the dissection and lower than the walls around the edges. When I painted this undermining is displayed through the sclera and the effect of limbo. A blade can also be produced Carefully tinting the surface of the sclera or iris.
The sclera is again introduced in the *** making sure that the floor of the dissection is parallel the plane of the body and is perpendicular to the line of sight. When the floor of the cut is properly aligned, the anterior portion of the sclera is reduced by at least 1 mm. substantially reduces the sclera around the iris location allows a depth of 1-1 ½ mm above the floor of the dissection. The cutting edge Iris maintains a strong angle.
The sclera is ready to be dyed. A cotton swab with a ball of wax is starting at each end as a handle while tinting. A sclera in children is usually blue. In adults with fair skin is light blue or green. With the darker-skinned people of the sclera tends to be darker, showing shades of brown-orange. A yellow pigment is applied to the edge area, except in children. The blood vessels to be painted on or a simulated by red rayon or cotton fiber is applied to the sclera and held in place with a spray of clear acrylic resin. If necessary, the iris is painted trim to represent the limbo.
The sclera is returned to the lower half of the bottle and the painting of the iris is positioned in the cutout. Now the eye prosthesis is ready to be packed with transparent acrylic resin. Care must be taken to avoid trapping air between the iris and the painting of the mass of acrylic. A fine blend of clear, cold-cure acrylic resin flowed over the iris and sclera and cure in a pressure cooker before the clear resin, heat-cure acrylic is packed.
After the curing process of the eye recovers from the bottle, finishing, and polishing. On delivery, the prosthesis should be checked for correct size, open the lid, and outlines. At this point it is important to note the high lights of the natural eye and the prosthesis. Highlights must match as closely as possible. If not, selective grinding on the corneal surface of the prosthesis is going to change the position of the highlights.
Iris illustration with acrylic paints on watercolor paper discs. The colors used are titanium white, ultramarine blue, burnt sienna blue, yellow ocher, cadmium yellow and crimson alizarin. Greens should be avoided to become very much alive when incorporated into the acrylic resin. To simulate the green, olive tones should be used. Black ink is required for a purple color. The paintings are mixed with water to obtain a heavy consistency. If mixture is too fine, You Will not get True Color and paintings tend to coalesce. Only a small amount of paint should be mixed at a time as the paint dries quickly.
Cold-pressed watercolor paper imperial grade is used. paper discs are cut in graduations of 0.5 mm, ranging from 10.0 to 12.0mm. paper discs are cut in graduations of 0.5 mm, ranging from 10.0 to 12.0mm. Paper accurate strokes with rounds are desirable to avoid the jagged edges in the finished denture. A correctly sized disk is glued to a paper strip of the type which is cut the disc. This band will offer a handle and simplify the management of small hard in the paint. It also provides a convenient place to test paint mixture.
There are five basic parts of a painting of the iris: the pupil, the base color, detail, impeller, and the limbo. The pupil is painted first and is in the iris center of the disc. A circle the correct size on disk is drawn with black India ink and then filled in. The size of the pupil is judged by the shade natural eye with his hand and observing the variation in size as it is exposed to light. In general, the average of the extremes there is a student at an acceptable size.
The first step in painting the iris is the base color. The base color is the darkest color that can be seen in the natural iris is usually blue, brown, olive, gray, or a combination of these colors. This layer is applied in a thick brush strokes to ensure that the disc is completely transformed. The iris is developed in layers of colors will darker to lighter colors. Thin radial lines form the striations and give an illusion of depth. The point must be very fine brush for delicate striations can be produced. A small area around the pupil is left unpainted. This afternoon will be painted to meet the impeller. Once dry, the paint used for shadow iris should be a shade darker than the iris to be added to the extent that these paintings have a tendency to lighten and brighten after being processed. Viewing the paintings when wet or covered with a drop of water will help to walk in the shadows. The impeller is then painted and is usually a bit brighter than the base color. Finally add the limbo. This can be painted on the side of the iris, but is most often painted on the eroded edge of the iris cut down on the sclera. The color used to paint the limb is usually a shade that blends painting the iris to the sclera.
While acrylic paints are the most popular. Watercolors also be used. However, watercolors are longer, and drying time should be allowed between each step of the painting to prevent colors from running together. Furthermore, watercolors are not as stable color nor as durable as acrylic paints.
Iris illustration, with oil paints on acetate discs, The paint colors used oil are Navy Blue, cerulean blue, cadmium red, cadmium yellow deep, cadmium orange, burnt sienna, burnt umber, black and titanium white. There two methods of using oil paint painting iris records. The first uses a solution of mono-poly (acrylic monomer clear polymer thickener) as a thinning and curing agent. The paints are applied in black acetate disc is covered performing a corneal button transparent acrylic resin. The second method uses linseed oil as a paint thinner.
Iris painting using mono-poly. Mono-poly is made by combining of ten parts that heat-cured acrylic monomer to one part acrylic polymer by weight. To combine the monomer and polymer water pan is heated and brought to a slight boil. The monomer is poured into a pitcher. The glass is placed in the pan of boiling water and when it is hot the monomer, the polymer hangs in the monomer slowly, stirring continuously with a glass rod. Two viscosity of this solution are required. After 10 minutes the liquid solution the viscosity of a light oil. Most of this solution is poured into a dark glass bottle and stored. The rest is returned to the boiling water until mixture reaches about twice the viscosity of the mixture first. The second mixture is also stored in a dark glass bottle. The thinner of the two solutions is used as the thinning and curing agents for oil paint, while the thicker one is used to adhere the painted iris disk in the corneal button.
In this method the student joins in the corneal button. Therefore any consideration of pupil size or location is required during painting iris. The paint is applied to the disc in a similar way the method described above. The paint for the base layer is mixed and thinned with mono-poly and applied to the disc with strong strokes that cover the entire disk. Several layers of paint apply until the disc is well covered and a striated effect is achieved. The painting of the iris is completed in the same way with the lighter tones to match the rest of iris. The impeller is painted one last time and is applied in a starburst pattern around the center of the disc. The corneal button is placed in the top of the painted disc to check the size and location of the impeller. The adjustments to their size or location can be made in this round. The blade is painted around the edge of the disc in a tone properly mixed paint on the white iris. The painted iris disk is checked for color accuracy against the natural eye by placing a drop of water in the iris painted.
The painting of the iris is inserted into the corneal button by applying a thicker layer of mono-poly to contact and sliding surfaces gently together careful not to trap air bubbles between the surfaces. When in correct alignment, the two sections are pressed together and dried.
For buttons of the cornea with the student built, clear acrylic resin is packed and processed in a specially prepared flask iris button. Once processed, the buttons iris should not be removed from the flask. With round burs of different sizes that correspond to the sizes of the students, drilling a hole in the surface of the button button. The stem button is visible from the bottom and is used as a guide to locate the center of the disc. The holes should be about 2 mm deep. This will be deep enough to create a black student after the button is finished and polished, but not deep enough to give the pupil high or rounded appearance when the prosthesis viewed from the side. The holes should be moistened with monomer and filled with acrylic resin which has been stained. Black the flask should be reassembled and processed. The flask is placed in cold water and slowly boil. It should boil for 30 minutes. It then must be removed from the flask and the bottom surface of the button should be crushed by milling a flat surface covered with a fine emery cloth. Milling remove any black acrylic resin outside the pupil area.
Iris artwork with oil paint and linseed oil. The method of illustration of the iris with oil paint and linseed oil differs very little from the method of mono-poly. The disk used in this method is transparent with a papillary hole in the center. The hole in the pupil may be enlarged with a small rattail file corresponds to the size of the pupil of the natural eye. The easiest way to operate this type of disc is the insertion of a peak cotton pliers, which have had a small slot cut in them, through the pupillary opening. The tension of the clamp will hold the disc in the slot in the process painting. The colors are selected and mixed with linseed oil as a thinning agent. The inner and outer surfaces of the disc is completely covered with the base color, leaving an area around the pupil unpainted impeller. After the base coat is applied the disc is finished by the methods described above.
After the disk has been painted the iris should be placed in an oven at 125 to 1400F for a period of 4-6 hours. The corneal button is now filled with acrylic resin transparent iris button on the bottle. Painted corneal button is placed on the mass of acrylic resin and tested packaging. The flash is removed and at this time a disk is placed black acetate painting behind the iris. The black disk for the student in the finished denture. The corneal button is recovered and processed the flash is trimmed. The button is polished, preserving his mother.
Sclera training. A wax pattern is obtained and contoured in the same manner as described above. When you are satisfied with the size and shape of the wax sclera, the iris is located. The wax inside the circle is taken to a depth of 3-3 mm and iris button is placed within this cavity. The wax pattern with the corneal button in place is inserted into the cavity of the eye. Using the stem as a handle, the iris is adjusted to match the position and look of the natural iris. After removing the wax from the sclera and iris take care of the iris is waxed into position and all turned to the wall to check their position. The wax pattern is invested and processed as described above. The mother in the corneal button can retain the mark in the upper half of the bottle and is the correct relationship to the sclera. After the acrylic sclera is retrieved from the bottle with built-button, the stem is extracted and polish the denture. At this time the sclera is reinvested in a flask. This allows a reduction of the anterior surface and staining. We must prevent painting over stained area of the diaphragm. The sclera is returned to the flask and processed with transparent acrylic resin.
instruction the patient. The method of insertion and removal of the prosthesis and care that the patient is shown. The prosthesis must be removed at least one once a day for cleaning. The prosthesis should not be allowed to come into contact with alcohol or solvents of any kind as this could cause cracks in the resin acrylic. If the eye should be lined must be returned for polishing.
Modifying a stock ocular prosthesis. An eye value is selected with the correct size of the iris, the sclera color and approximate shape. Peripheral and posterior surfaces and the reduction of 2-3 mm and the slots retention are cut into the posterior surfaces. A small, straight stick is secured with sticky wax on the pupil perpendicular to the plane of the iris. This club act as a handle and as a guide for the alignment of the prosthesis in the right relationship to the natural eye.
A small amount of hydrocolloid irreversible is mixed with warm water and placed on the posterior surface of the prosthesis. With the patient looking straight ahead at a distant site, the prosthesis and media are installed between the covers and seated in the socket. Care must be taken to avoid trapping air between the print and the fabric surface. The handle is used to carry the prosthesis in proper alignment with the natural eye and lids, opening and verifying the edge.
The impression is removed and print media Trim the excess properly. The stick handle is removed from the anterior surface of the prosthesis. The prosthesis and the feeling invested in the lower half of a flask. After stone has set, two small projections of self-curing acrylic resin are attached to edge areas of the prosthesis. These projections are maintained prosthesis in the upper half of the flask and maintain the proper relationship between the prosthesis and the mold during packing and processing procedures. The use of half separation all stone surfaces exposed, the top half of the flask is poured. The packing, processing and finishing of the prosthesis is carried out as described above.
Complications *
Ptosis. Ptosis can be divided into two major categories for the purposes of resolution for the ocular prosthesis: pseudoptosis and true ptosis. Pseudoptosis occurs when the upper lid does not get enough support for the prosthetic eye. This problem is usually simple are solved by modifying the prosthetic eye contour to properly support and replace the lid.
A more difficult situation arises when a true ptosis exists. Due to inadequate muscle tone or lack of tissue, the upper lid falls on the prosthesis. The correction of ptosis often can be achieved surgically by shortening of a muscle or reduce the volume of tissue. However, in many special situations contour of the prosthesis will alleviate the problem. Allen describes a method contour of the prosthesis to overcome the ptosis. First, the upper surface of the cornea is enlarged prominence to lift the lid. Then the upper surface of the prosthesis is reduced to form a platform or depressed area in which the lid can rest and retire. A small bump is placed behind the cover to make it appear full.
Lower drop cap. Fall of the lower lid can sometimes be solved in a similar manner. By eliminating some of the underside of the anterior prominence of the prosthesis pressure forcing the lid down is reduced. The material is then added to the prosthesis behind the cover in an attempt to push the cover off and allow to rise. A second solution is to remodel the underside of the denture and place pressure on the middle and lateral areas where the lower eyelid is more support. The medial and lateral aspects of the bottom edge are elongated and the core is thinned and shortened.
Another problem. Other situations that can cause problems and can be corrected surgically (Reen and Beyer, 1976) are entropion and ectropion. When the contours of the bottom cover or the position of the tabs leave unsightly appearance, care contour wax pattern or relieve pressure on the lid and increase support for correct times the situation without surgery.
As aging occurs, patients lose tone and elasticity of tissues in many areas of the body. The upper lid and bottom are equally affected. Pay special should be to outline a prosthesis for a geriatric patient to overcome the problems of tissue tone. Blepharosulcus is not rare and special configurations to minimize aesthetic problems in aging patients may be needed (Guibor, 1976).
Sometimes scar bands or adhesions that are attached to the wall of the cavity of the eyelids (symblepharon). These bands scar reducing the mobility of the prosthesis or prevent its production. making surgical revision in conjunction with a pressure device is sometimes effective to remove these scars bands. In some patients, ocular prosthesis can be use by placing a groove in which the band of the scar can rest, but the mobility of the prosthesis is compromised.
A contract connector can occur after trauma or infection or when a patient does not use a prosthesis for an extended period. The result is the loss of a suitable path keep the prosthesis. To compensate for this loss, making expansion can be obtained by applying pressure with a prosthetic enlargement. effective extensions can be made over time. A mere superficial culture-de-sac can be satisfied by the contour of the underside of the prosthesis as suggested inclined lower eyelid.
Evisceration is increasingly popular as a treatment modality. The evisceration of the contents of the world instead of across the globe have been eliminated. An implant may be or may not be used, but recommended the establishment. The cornea is often left intact. To reduce the incidence of elceration and abrasion of the cornea or possible loss implant, a prosthesis of shares should not be used. Instead, an eye must be custom manufactured. A print allows the fabrication of an ocular prosthesis intimate contact with the bed of tissues and distributes pressure more evenly which makes an eye values.
RESTORATION OF ORBITAL DEFECTS
Orbital prostheses that aesthetics is a tougher challenge. Because conversation with others begins with eye contact, small discrepancies in the position of the eyes, contour of the lid, and the color of the prosthesis was noted immediately by the observer. In some patients may not be possible to duplicate the look and shape of the normal eye and other orbital adjacent structures. In particular orbital defects, unsightly prosthesis creates more psychological trauma than in all prostheses.
Preoperative consultation is useful to inform the patient of the nature the defect and the options available for restoration. Unfortunately, many patients have the impression that the prosthesis will move and function in concert with his remaining eye. Photographs of the restoration of denture similar defects are useful in eliminating this misconception. In most patients is not necessary to obtain preoperative photographs or prints, as they are of little value in making the prosthesis postoperatively.
Resection surgery for tumors of the orbit depends on the nature and extent of the tumor. Resections that are confined to the removal of orbital contents lead to defects that are more easier to restore aesthetics. Since the surgical margins extend beyond the limits orbital prostheses are less aesthetic result the inability to camouflage the tie lines between the skin and prosthesis. Moreover, as the prosthesis extends beyond the orbit, furniture woven beds can be found resulting in an increased exposure of the tie lines.
The surgeon should be instructed to line the bony walls of the orbit skin. In most cases attempts should not be the occlusion of the orbit with local or distant flaps of tissue. After such reconstruction, little space is left for the placement of a right orbital. Furthermore, recognition of the recurrent tumor may be delayed due to the margins of resection are not clearly visible.
Impressions
impressions precise orbital defects are difficult to obtain because the periorbital tissues are easily displaced. The displacement of the tissues is particularly difficult to avoid when dealing with patients who have had a total maxillectomy and orbital exenteration as for the cheek area is not supported by bone. In these patients, the shutter should be made permanent, properly bent, and placed correctly before proceeding with the impressions of the orbital area.
At first, a moulage face is obtained and the resultant to an impression tray that is manufactured teacher. Unless the bone retention of the orbit is to be made, the tray is not necessary that extend significantly in the orbital cavity. The purpose of printing is to record the bed orbital and periorbital tissues as accurately as possible. For that the patient should be placed in an upright position and great care taken not to move the bed of tissue. Before you get the impression, undesirable undercut areas should be blocked with vaseline gauze. irreversible hydrocolloid impression material is adequate, but other materials such as silicone or reversible hydrocolloid, are also appropriate. The media is getting injections into the skin folds smaller and remote areas and the tray loaded with impression material gently tease in position. The tray is suspended in the appropriate position, taking care not to compress the tissue. When using irreversible hydrocolloid and additional water is added to the mix, material viscosity is reduced resulting in less compression of tissue bed. During the procedure the patient should keep your eye open and remaining attached to a distant point of full ahead. This will prevent unwanted muscle contraction residual cap and avoid distortion of the defect. After removal, the portion of the Printing may require support. This support can be set either with nails or wire, if necessary. A mold is then made of stone. A hole must be drilled through posterior orbital wall to facilitate movement and adjustment of the portion of the ocular prosthesis.
Sculpture
An ocular prosthesis action is selected that approximates the color and size of the iris and sclera of remaining eye. In general, the ocular prosthesis should be reduced in size by up to fit easily into the defect of the orbit in the right position. Stationery Aluminum is so intimately with the cast. Clay or wax is used as the medium of sculpture. The ocular prosthesis is present in the medium of choice and the whole apparatus is transferred the patient. The ocular prosthesis is placed to simulate the position of the left eye, with patients, focusing on a distant point forward. The patient should be in Standing in a relaxed position, holding a colleague prosthesis in place while the clinician assesses the eye position. A reference mark is placed in the midline and either a tongue or a Boley gauge can be used to confirm the position modiolateral. Students may be used as benchmarks in this evaluation. Mediolateral, anteroposterior, and inferior-superior position of the ocular prosthesis must imitate exactly the normal eye position if successful prosthesis is to be manufactured. The smallest difference in eye position is immediately noticeable, even the most casual observer. Before accepting what appears to be a proper eye position, verification should be performed by additional observers.
In the next round sculpture periorbital tissues is carried out. To ensure the proper contour cover the normal eye, the sculpture should be made during the middle portion of the day. The patient should be rested and relaxed, fatigue and anxiety affect lid contours dramatically in many patients. Cover edges and periorbital tissues are similar to the normal eye to the greatest extent possible. All information must be faithfully reproduced. The seams should be finished with feathers and below the glasses or the shadows cast by them. Without the use of spectacle frames of the tie lines are quite evident. The best results were obtained in elderly patients with fissures many lines and periorbital tissues. If possible, the tie lines must not extend beyond the area covered by eyeglass frames, margins are difficult to camouflage. Plastic eyeglass frames are generally preferable to metal frames, because they cast larger shadows in which the tie lines can be placed. In addition, if desired orbital prosthesis can be more easily mounted on plastic structures to those of metal.
Material selection and processing
Manufacture of molded products as usual, except that the ocular prosthesis must be removed. If the prosthesis is to be processed acrylic resin, this is achieved by pouring a layer of stone over the entire surface of the external prosthesis carved. The ocular prosthesis is carefully removed through the hole previously made in the posterior wall of the cast. This task should be carried out without altering the lid and canthal areas. Only the material of sculpture directly posterior to the ocular prosthesis should be removed. Dental stone is then gently vibrate through the rear opening and filling the portion previously occupied through the eye of acrylic resin. If a flexible material is used for facial prosthesis the eye must be duplicated and inserted into the appropriate position in the mold (Challis et al, 1971; Bulbulian, 1973).
Selection of material for processing depends on physician preference. Methyl mehacrylate prefer for a prosthesis limited to the orbital area. Acrylic resin is the longest duration of the available materials and allows the insertion of the prosthesis to eyeglass frames. In addition, from the tissue bed is rarely moving, the rigidity of the acrylic resin is rarely confusing for the patient. In our experience, flexible materials become an advantage when the defect extends beyond the orbital area and is movable tissue beds.
The prosthesis is processed in the favored material stains well intrinsic or extrinsic, or both. Prosthetics tabs are attached to the top cover before the reintegration of acrylic eyes. Usually, lashes, commercially available, need to be thinned to make a normal appearance. Since the lower lashes are quire rare, their presence can be simulated with a few vertical lines of paint since the extrinsic lower eyelid. The eyebrows, if necessary, can be replaced with good Eyebrow Pencil or brow prosthetics to measure. If the prosthesis is transformed into methyl methacrylate, acrylic resin eye is secured in the position of self-curing acrylic resin. Following anchor acrylic eyes, a small amount of clear self-curing acrylic resin is added to the inner and outer edge. The portion of the song then can be colored and easily blended into the adjacent sclera.
Retention. Retention of orbital prosthesis can be achieved in several ways. adhesives on the skin are most commonly used and perform well. In some patients, withholding commitment orbital with a flexible material is sufficient to maintain prosthesis.
The above methods work well in limited defects of the orbits. However, when a patient has undergone maxillectomy in combination with a total orbital exenteration, retention achieved by placing the ocular prosthesis frameworks can be helpful. Eyeglass frames to simplify placement of orbital prostheses and more accurate, reproducible positioning of the restoration. Accurate positioning is particularly difficult in the orbital tissue defects compressible beds as seen in patients with total maxillectomy defects. Obviously the least error is the position of calling attention to the prosthesis. If glasses frames are used for retention, either one eye patch or a custom reproduction of orbital prosthesis to be produced for the patient. When mounts glasses are used, care should be taken by the optometrist to prepare the lens on the prosthesis so that it is identical to the eye lens that covers normal or asymmetric distortion of the prosthesis will be perceived.
Advantages of plastic acrylic eyes on glass eyes.
1. It offers the freedom of the fragility and etduing area resulting from the dissolution by secretions socket.
2. Since the replacement is custom made, adjust the size and shape is easier to make to compensate for irregularities that are so common socket.
3. Other features can be adapted to the different aesthetic requirements, such as the limbus, anterior chamber depth, the diameter of the cornea, pupil, and episderat cyclical and vessels. It is possible only by the assembly strictly anatomical parts everywhere.
4. There is a real three-dimensional effect is this construction as a result of clear resin suspension of a transparent perforated disc, which has been painted on both sides. This effect is reinforced by placing a disk in a jet black student distance posterior iris disk.
5. Prefabricated iris scan button to be stored, so the operator knows, first the exact Color Iris in a complete denture.
6. The plastic eye eliminates the time consuming steps such as the construction of multiple mold polishing accuracy of the camera angle.
7. The method is easy to teach, dental staff can be trained in a relatively short time to carry out all stages of manufacture.
8. The glass eye has the disadvantage of being extremely fragite.
9. A glass eye (prosthesis) can sometimes explode spontaneously in the eye and will require careful solvent extraction of sharp fragment by an ophthalmologist.
10. In addition, the glass surface affected when the fluids from the wall cause itching can be extremely irritating to the membranes socket.
11. glass restorations are also difficult to fit well in relation to defects and variations, so that very often the prosthesis is too small, giving the user the appearance of evophihalmos.
CARE of the prosthesis
Proper maintenance of the prosthesis is of vital importance for reasons of hygiene and aesthetics
1. The prosthesis must be removed at least once a day to clean.
2. The adhesive should be removed with a rocking motion of the ball of the finger or thumb in the direction the boundaries of the unit.
3. All surfaces of the prosthesis should be cleaned with mild soap and a brush.
4. The slim in contact with the prosthesis must be thoroughly cleaned and carefully.
5. The patient is carefully directed to remove and stop using the prosthesis should any irritation occur when prosthesis contacts the tissue and to see a prosthodontist as soon as possible for treatment.
INSTRUCTIONS the patient
The daily placement of the prosthesis will be a success for the patient follows the instructions given, which are:
1. To keep the area clean and dry and without oil.
2. To keep clean the prosthesis.
3. To replace the prosthesis as shown.
4. Adhesive should not be taken before the prosthesis is replaced.
5. Accession if used should be as little as possible and not too often.
6. For look, look in one or more mirrors to place the prosthesis.
This will help the patient put in its proper relation to the surrounding anatomy.
7. To keep the device in place with finger pressure for 5 minutes.
8. To check all the edges by the use of the mirror for adaptation complete all surfaces.
The surfaces of the prostheses are made to fit the support areas, so it must match exactly.
9. For avoid too much has been exposed to direct sunlight.
10. daily cleaning and care will help prevent hardening of the prosthesis caused by waste of the nasal skin and sections.
11. The patient must always remember that the prosthesis is exposed to conditions that cause changes in its basic color.
The basic color surroundly areas may also change as a result of sunlauning, exposure, diners, etc.
In cases it may be necessary replace the prosthesis with a fixed color.
LABORATORY SERVICES
Apart from consumables (Cera, investment, metal mold construction, etc) the main laboratory equipment is as follows.
1. Double boiler and Bunsen burner with tripod Asbestos and notes:
This equipment is used to prepare material for reversible hydrocolloid used in making printing defect in doubling patient procedures for the construction of the mold.
2. Rings large investments Galunized sheet metal:
These are used investment of the models was of the molds to be built.
3. A large dry heat oven:
This is used to remove moisture from the investment after removal and was in the heat of investment and to ensure adequate thermal expansion before issuing proceedings.
4. Square jaw pliers:
These are used to manipulate the molds.
5. Nail asbestos:
These are essential because they allow early management of inverted models before, during and after calculating the actual cost of the molds.
6. Melting Pot Cast of large burner and tripod:
This configuration is used in the foundry and metal linotype and bring it to the desired casting temperature before casting molds.
7. Large water bath.
8. The saw and blades
9. Vice
10. Lalthe Bank
Eye prosthesis
The authors have found their ocular prostheses for increased retention of neodymium magnets housed in a super company within the orbit. The superstructure is derived from the implants placed in either the lateral half of the superior orbital ridge or lateral third of the infraorbital ridge where the bone becomes thicker that binds to the infraorbital ridge where the bone becomes thicker as it merges with the zygomatic bone. For some cases both sites are used, especially if the prosthesis orbital contains a component of the facial skin and therefore requires bigger and heavier. Because the orbit is circular, the coverage of the pillars towards the center of the orbit. Therefore, the risk of contact with the pillars and the limitation of the superstructure is present. It is advisable to space the implants at least 1 cm apart and consider their departure angle in the orbit.
In such cases, implants of 4.5 mm 4.0 mm 'long are more common. However, sometimes a thin bone may have to suffice with 4.0 mm 0.5 mm '3 implants and bone anatomically thicker can accommodate lengths of 6.0 mm. For evaluate the thickness of the bone to choose both the best site for better implants and implant length, CT is necessary.
About the Author
i m prosthodontist. working as assisatnt professor t GOVT. DENTAL .ROHTAK INDIA.
