Anophthalmia or anophthalmic socket describes an eye socket without an eye.
Rehabilitation of an anophthalmic socket can involve the eyelids and orbit.
An orbital implant that provides adequate volume.
There are various materials and types of orbital implants, and the benefits of each can be discussed during your consultation. This will contribute to the axial position of the prosthesis and has implications on the position and function of the eyelids. Dr. Isaacs can also improve orbital volume with dermis fat grafts (see publication), and secondary synthetic implant exchange, placement, or modification.
A prosthesis that moves well.
It is difficult enough to only function with one eye. The appearance of the prosthesis should be made to match the other, healthy eye for a natural appearance. A large part of this is how well the prosthesis moves, and matches the other eye during movement. Some of this depends on the orbital implant, some of it on the prosthesis, some on the type of surgery that was performed, and some on the relationship between the orbital implant and prosthesis. Dr. Isaacs has experience with removing, exchanging, and modifying implants to achieve the desired results.
Appropriate eyelid contour.
The right relationship between the size and position of the orbital implant and the size and shape of the prosthesis can achieve a natural eyelid contour. Sometimes surgery is required to achieve the desired result. Segmental eyelid surgery can be performed to achieve a natural result. Lateral canthoplasty can also be performed to improve the eyelid contour.
Appropriate eyelid position and function.
The levator muscle elevates the eyelid. The eyelid and muscle act against the prosthesis to function. The size and shape of the prosthesis has an effect on eyelid position and function. Also, the axial position and size of the orbital implant can affect the eyelid position. The more optimal these are, the more optimal the eyelid muscle can function. Sometimes surgery is required to achieve the desired result. Dr. Isaacs performs both anterior and posterior approach ptosis (droopy eyelid) surgery. This surgery can come down to millimeters; so, precise surgical planning is required.
Appropriate prosthesis fit.
Wearing the prosthesis is around the clock, because it will also help retain the integrity of socket and prevent shrinkage. A comfortable and appropriate fit is therefore important. If the prosthesis is too large, it can push the lower eyelid down, cause giant papillary conjunctivitis, and cause discharge, itching, and mucous collection. If it is too small or inappropriately fitted, it can continuously fall out. Eyelid surgery can be performed, such as a lateral canthoplasty, ptosis surgery, or ectropion surgery.