A 58-year-old male patient reported to Department of Prosthodontics for the fabrication of a fixed partial denture for the replacement of missing teeth. Examination and history revealed that the patient had suffered from chemical burn (ammonia gas) in his left eye. Following trauma, an enucleation was done. After 5 months of surgical intervention, a stock prosthesis was given to the patient. However, the patient was dissatisfied with the esthetics and the fit of the prosthesis. The patient was given an option of an implant-retained ocular prosthesis but the patient was not ready to take up the surgery purely due to economic reasons. So it was decided that a custom-made ocular prosthesis which would enhance esthetic and functional results would be the best to meet the needs of the patient.
The goal of palliative care is the achievement of the best quality of life for patients and their families. Eyes are generally the first features of the face to be noticed. Loss of an eye is a traumatic event which has a crippling effect on the psychology of the patient. Several ocular and orbital disorders require surgical intervention that may result in ocular defects. An ocular prosthesis is fabricated to restore the structure, function, and cosmetics of the defects created by such conditions. Although an implant eye prosthesis has a superior outcome, due to economic factors it may not be a feasible option for all patients. Therefore, a custom-made ocular prosthesis is a good alternative. This case report presents a palliative treatment for a patient with an enucleated eye by fabricating a custom ocular prosthesis which improved his psychological, physical, social, functional, emotional and spiritual needs.
Ocular Prosthesis | Eye Centers of Florida
With this experience, it is possible to use methods and materials available today to create extremely realistic prosthetic eyes allowing the ocularist to restore the loss to its natural appearance in match and mobility.
Evaluation of Ocular Prosthesis Biofilm and …
An ocular prosthesis can be either readymade (stock) or custom-made. Stock prosthesis comes in standard sizes, shapes, and colors. They can be used for interim or postoperative purposes.[,–] Custom eyes have several advantages including better mobility, even distribution of pressure due to equal movement thereby reducing the incidence of ulceration, improved fit, comfort, and adaptation, improved facial contours, and enhanced esthetics gained from the control over the size of the iris, pupil, and color of the iris and sclera.[,,]
Evaluation of iris color stability in ocular prosthesis.
Frequently, an implant is placed in the tissue bed to facilitate the construction of an ocular prosthesis. The purpose of ocular implants is to replace the lost tissue volume and improve prosthesis mobility. There are three basic types: Buried, semiburied; integrated, buried;semi-integrated. Buried; semi-integrated implants are the most common method of replacing the volume loss in the socket following enucleation or evisceration. Modern ocular implants are available in various materials like metal, silicone, hydroxyapatite, or acrylic resin. However, the principal complication associated with ocular implants is the erosion of the overlying tissue, resulting in the exposure of the implant or contamination of the implants at the time of insertion.
Evaluation of Ocular Prosthesis …
For example, if an OT and PT are co-treating a patient with sitting balance and ADL deficits for 30 minutes, then only 2 units total can be billed to the patient: either 2 units of OT only; 2 units of PT only; or 1 unit of OT and 1 unit of PT.Utilization Guidelines and Maximum Billable Units per Date of Service
Rarely, except during an evaluation, should therapy session length be greater than 30-60 minutes.
clinical use and the evaluation of the ocular prosthesis, ..
Do not include unbillable time, such as time for: Examples of treatment time documentation
A treatment session includes 20 minutes therapeutic exercise (97110), 15 minutes therapeutic activities (97530) and 20 minutes unattended electrical stimulation (G0283).
Time documentation in the treatment note
A 30 minute OT initial evaluation is completed (97003), followed by 20 minutes fluidotherapy (97022).
Time documentation in the treatment note
A discharge note is required for each episode of treatment and must be written by the clinician.