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Advances in Neuroprosthetics
Published in Chang S. Nam, Anton Nijholt, Fabien Lotte, Brain–Computer Interfaces Handbook, 2018
Ocular prosthetics are another matter: From their earliest known uses in 2900–2800 BC Iran and fifth century BC Rome and Egypt until the recent advent of functional ocular neuroprosthetics, their purpose has been aesthetic (and in Antiquity, often religious or symbolic) rather than the restoration of vision (Pine et al. 2016; Bowden et al., ongoing research).
Orbital resection and reconstruction
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
The basic requirements for an exenterated socket that can maintain an ocular prosthesis are (1) orbital tissue volume to support the prosthesis, (2) a mucous membrane surface with fornices to accommodate the prosthesis and (3) eyelids to hold the prosthesis within the socket. The limiting factor in most exenteration cases is the preservation of a mucosal surface, which is essential if the prosthetic shell is to be comfortable. Unless significant portions of the conjunctiva can be retained, an ocular prosthesis is not a rehabilitative option after orbital exenteration, and the surgical plan should take this into account.
Life Care Planning for the Visually Impaired*
Published in Roger O. Weed, Debra E. Berens, Life Care Planning and Case Management Handbook, 2018
Roger O. Weed, Rasheeda Wilkins
Special issues occur in very young children with visual impairment (Dodson-Burk & Hill, 1989; Teplin, 1995; Matthews, 1996). In fact, the child's development depends upon the severity of the visual impairment, type of visual loss, and age at onset of the vision deficit. The National Information Center for Children and Youth with Disabilities reports that a young child with visual impairment has little reason to explore interesting objects in the environment and misses opportunities to have experiences to learn. This lack of exploring will continue until learning becomes motivating or until intervention begins. Children with visual impairment may be unable to imitate social behavior and understand nonverbal cues because they are unable to see peers or parents. This creates obstacles to a growing child's independence. It is imperative that children with visual impairment be assessed early and receive appropriate interventions. They will require ongoing assessment as they grow and develop. An interdisciplinary approach will be beneficial in teaching self-care and daily living skills, as well as approaching educational and vocational issues. Deutsch and Sawyer (2003) have pointed out that even relatively minor impairment can result in vocational handicaps that limit the range of job alternatives available to an individual and reduce earning capacity. An example is color blindness, which can reduce the range of job opportunities that would otherwise be available. The degree to which total blindness results in permanent impairment and loss of earning capacity varies with the individual and depends on many personal and vocational factors. An infant or young child who has sustained the loss of an eye will require multiple careful follow-up appointments with the placement and replacement of an ocular prosthesis and conformer to promote development of the orbit. Failure to do this will result in some deformity of the forehead and face and will not allow placement of a cosmetic prosthesis.
Psychosocial factors among patients undergoing orbital exenteration
Published in Clinical and Experimental Optometry, 2023
Neelima Balakrishnan, Sahil Agrawal, Rachna Bhargava, Veena Jain, Neelam Pushker, Rachna Meel, Mandeep S. Bajaj
Rehabilitation following exenteration includes fitting the patient with an ocular prosthesis, which has psychological consequences of its own. Significant distress was noted in a considerable proportion of patients rehabilitated with ocular prosthesis.34 Dissatisfaction with the prosthesis may also impact its use. In one study, it has been found that only 11.8% of patients who underwent sub-total exenteration with an ocular prosthesis did not wear an eye patch. This meant that despite attempts to rehabilitate the patient with prosthesis, the patients still chose to hide the prosthesis due to their dissatisfaction with its appearance.35 This may limit the willingness of a patient to follow-up as well as the compliance to further treatment. The psychosocial impact and satisfaction with the prosthesis in spectacle prosthesis wearers for more than 3 months duration after exenteration was also studied (group II). The duration of use of prosthesis ranged in the patients from 3 to 6 months and the mean duration was 4.25 months. The severity of depression was moderately severe in 70% patients and anxiety was mild in 50% and moderate in 40% patients.
Analysis of microbial communities of ocular prostheses and anophthalmic sockets using 16S rRNA gene sequencing
Published in Biofouling, 2023
L. R Makrakis, V. C Oliveira, E. S Santos, C Nascimento, E Watanabe, A. B Ribeiro, C. H Silva-Lovato
Several reasons, including injury or trauma, diseases (i.e. cancer, glaucoma, or diabetes), infections, or congenital disorders can lead to eye loss (Modugno et al. 2013). According to the individual’s specific needs, patients can be rehabilitated with an ocular prosthesis designed to replace the missing eye. The prostheses are typically manufactured from acrylic resin or glass and are custom-made for each patient to closely resemble the appearance of a natural eye (Modugno et al. 2013; Goiato et al. 2014). Ocular rehabilitation is related to improved self-esteem and overall quality of life (Nivean et al. 2022; Ruiters et al. 2021; Makrakis et al. 2021). To prevent further complications, adequate maintenance of the ocular prostheses is necessary, and to achieve this, the scientific literature has suggested professional polishing and regular hygiene (Bonaque-González et al. 2015; Penitente et al. 2022). Polishing is a valuable strategy for reducing the number of microorganisms and incidences of inflammation over time (Penitente et al. 2022). According to Penitente et al. (2022), repolishing reduces surface roughness and improves humidity, which negatively influences bacterial adhesion. Regarding routine hygiene, although there is general agreement on the importance of the cleaning regimen of ocular prostheses, no gold standard protocol has been defined (Paranhos et al. 2007; Bonaque-González et al. 2015; Pinheiro et al. 2018; Andreotti et al. 2023).
Custom ocular prosthesis-related concerns: patient feedback survey-based report vis-à-vis objective clinical grading scales
Published in Orbit, 2021
Tarjani Vivek Dave, Arpita Nayak, Mansha Palo, Yashwanth Goud, Dharani Tripuraneni, Sachin Gupta
The most common artificial eye-related concern noted in our survey was reduced motility of the ocular prosthesis as compared to the contralateral eye. This is in contrast with the study by Keith Pine et al.4 who found that watering, crusting and discharge were the chief concerns. A part of this could be explained by the fact that over 95% of ophthalmic plastic surgeons in this part of the world do not perform placement of a motility peg as a secondary procedure following socket surgery21 vs a slightly higher proportion of oculo-facial surgeons in the west22–24 performing pegging to enhance the motility of the prosthesis. Vishwanathan P et al.22 documented the trends of anophthalmic surgery in the UK and noted that 7% of the surgeons placed motility pegs in selected cases, usually as a secondary procedure and Su GW et al. reported pegs were used in 8.1% of all implants reported by the active members of American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS). The choice of implant material largely is based on three factors, i.e. availability, cost and experience of the surgeons with different implant materials.23 Since the most commonly used implants in our set up are the non-porous implants, pegging is performed rarely in this part of the world.21 This might be the reason for the relatively higher concern related to motility in our patients.