PMC4832803_01
Frontal view of the defect
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F1
Examination of the patient showed a large orbital defect on the left side [Figure 1] with no definite bony or soft tissue undercuts to aid in retention of the prosthesis.
Facial moulage reinforced with plaster of paris
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F2
Subsequently, a cast was obtained using dental stone type III (goldstone) [Figure 2].
Anophthalmic socket aperture blocked out
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F3
Since the anophthalmic socket had a redundant eyelid tissue, which was functional during the movement of contralateral eye, it was intended to be blocked out [Figure 3] before fabricating a heat polymerized acrylic resin (DPI, heat cure) base plate over it, which supported the overlying prosthesis.
Heat-cured base of acrylic resin
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F4
The fit of the base was checked on the cast [Figure 4] and later transferred to the patients face to check its stability by asking the patient to do functional movements such as smiling, opening and closing the eye, and raising the eye brow.
Trial positioning of the prosthesis (a) frontal view, (b) lateral view
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F5
Once the position was confirmed, the eyelids and the remaining portion was sculpted in wax and tried in the patient's orbital defect [Figure 5a and b].
Sculpted prosthesis with the duplicated cast was flasked
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F6
The wax sculpted prosthesis with the cast was flasked and dewaxed [Figure 6].
Dorsal view of finished prosthesis with eyelashes
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F7
Orbital rehabilitation (final outcome with patient wearing regular powered spectacle)
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F8
The prosthesis looked more naturally pleasing as patient used spectacle on his day to day basis as well as the atrophic side of the face looked comparatively better after the periorbital rehabilitation [Figure 8].