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"What is the Modified Impression Method? |
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I am frequently asked to indicate to a doctor or
patient something about my acrylic eye fitting
methods. I am more than happy to do so. There are several successive steps which I shall briefly describe here.
Adequate healing is required before fitting the acrylic eye. Schedule; permitting, I will fit the
prosthesis six to eight weeks after surgery. Upon arrival at my office, the patient will complete a registration form; which is the beginning of a record similar to
any kept by a medical doctor. |
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Why Take an Alginate Impression? |
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An impression of the shape of the space of the eye socket is
taken with alginate, which gels in about two minutes to the
consistency of the white of a hard boiled egg. Any discomfort
to the patient is minimal. After removal from the eye socket, a
two-piece mold is made using dental stone, a material very much
like plaster of paris, around the impression.
Taking an impression affords me the opportunity to design an
eye which provides total comfort in most cases and much improved
motility. No more removing the eye several times a day, or even
once a day. No more mopping up spilled mucous from the socket!
No more red, painful tissue.
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How is the Wax Pattern Made and Used? |
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After the dental stone has hardened, the impression material
is removed. Molten wax is then poured into the mold and allowed
to cool and harden. Upon removal from the mold, this wax piece
constitutes a pattern (for the artificial eye) which can easily
be changed in shape to improve the appearance and comfort to the
wearer.
An acrylic iris-cornea, which duplicates the patient's own
iris, is chosen and designed into the wax pattern. It can be
removed and placed in a different position in the pattern in
order to provide the proper direction of gaze, vertical and
horizontal positions, the desired prominence to the artificial
eye, and to provide the proper eyelid opening. This part of the
fitting procedure can take as much as several hours, during which
time the patient must remain available at ten to twenty minute
intervals for trial fitting.
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Is Knowledge of Anatomy Necessary? |
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Yes, it really is. In fact, one of the reasons why the
Modified Impression Method is so superior is because it
incorporates fitting principles based on a working knowledge of
the anatomy of the eye and orbit. Anatomical knowledge helps
insure that socket tissues will not be forced into abnormal,
irritating, or non-functional positions. |
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When Does the Prothesis Become Acrylic? |
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When all the improvements havebeen made in the wax pattern, a
new, final mold of that pattern is made, using dental stone, in a
brassflask. The wax is then removed; however, the iriscornea is
placed back into the mold in precisely the same position it had
occupied in the wax pattern. A dough of white acrylic is then
packed in the mold and processed under heat and pressure until
properly cured.
To view picture click here |
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How Is an Acrylic Eye Colored? |
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As soon as the eye is processed, a thin layer of the acrylic
is removed from the front surface in preparation for the
coloring. Veins (fine fibers of red embroidery thread) are then
painstakingly placed over the surface of the prosthesis in such a
manner as to duplicate the veining pattern of the companion eye.
The actual coloring of the eye is done with the greatest care
to match the companion eye and to present an appearance of living
tissue. This is done by a method devised in October 1976 and used
exclusively by those few discriminating ocularists who employ the
Modified Impression Method of making artificial eyes. The
patient must be present for this part of the work for perhaps two
or more hours. At intervals, the painted prosthesis is placed in
fhe patient's eye socket, then removed and the coloring altered.
This step is repeated until the coloring is fully
satisfactory. |
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At What Point is the Prosthesis Finished? |
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When the color is judged to be correct, the eye is returned
to the final mold and a layer of transparent acrylic is cured on
its front surface to protect the color during polishing and
wearing. The finished, highly polished prosthesis is then placed
in the eye socket and evaluated in all aspects. If it is not
correct in every way, changes are made until it meets my quality
standards.
To view picture click here |
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How Long Does It Take To Fabricate the Prosthesis? |
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The procedure normally takes two to two and
one-half days. If the eye socket is a very difficult
one to fit, it could take an additional one or two
days. While most other eye fitters take less time,
I have found that far superior prostheses are
produced by employing the time involved in the
Modified Impression Method. |
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Is the Prosthesis Expensive? |
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Past patients from many different states, and
from foreign countries, will attest to the fact that,
for almost every person, fine prosthetic work is
indeed a priceless blessing! My fees are
standard and reasonable for the quality,
craftsmanship, and amount of time invested in
the designing of this caliber of prosthesis. |
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Can the Prosthesis be Fitted Over Any Type of Implant? |
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Absolutely! An added benefit of fitting by this
very specific and exacting method makes it
possible for surgeons to place special implants in
the orbit at the time of eye removal. If such
sophisticated implants are fitted by older,
traditional methods, there can be danger of
pressure necrosis and eventual loss of the
implant; whereas, when such implants are fitted
by the Modified Impression Method, the
likelihood of comfortable retention is nearly one
hundred percent. |
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After the Eye is Finished, What Precaution Should the
Patient Take? |
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As one wears the eye over a period of time -six
months to one year - minute scratches appear
on the surface of the eye (caused by continual lid
action against the eye and by handling). These
scratches cause the eye to begin to appear dull
and can also cause some mattering problems.
Therefore, I recommend that the prosthesis be
polished in my office at least once a year to
assure proper comfort and cosmesis. I also
recommend that the patient see his
ophthalmologist at least once a year or as often
as the doctor directs. |
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Will a Refit Be Necessary? |
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Sometimes. A refit may be necessary from
time to time due to changes in volume and
arrangement of orbital and socket tissues. A refit
implies considerable reworking of the eye so that
it fits properly once again. Therefore, I will refit
only those eyes which I have previously designed
and fabricated, as long as the eye is not over
seven years old. I am happy to make minor
adjustments to an eye which is not over ten years
old. |
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What About a Blind, Unsightly Eye or Phthisical
Globe? |
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It is very common for a patient with an
unsightly blind eye or phthisical globe to desire a
comfortable "scleral shell." With my exacting
methods, this can comfortably and effectively be
done providing the cornea is not overly sensitive. |
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One Caution |
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As an ocularist (eye maker), I am not a miracle
worker. Because of the abilities, methods, and
procedures that I employ, it is true that I can
improve, almost without exception, on the
prosthesis that a patient has previously been
wearing. But it needs to be understood that,
especially in the case of severe trauma or
scarring, I may not be able to help the patient
appear entirely normal again. Always the best
that can be done will be done. |
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