During a normal everyday encounter we make eye contact at a normal social distance, about 1 meter. Or in passing a stranger, we share a glance. In either situation we often detect when something does not look quite right, especially when there is a lack of symmetry about the eyes. So when we design orbital prostheses among the many challenges we are faced with the one challenge we have control over is achieving accuracy and naturalism in a set gaze. Here we introduce a simple test to demonstrate the basic quality and effectiveness of our typical outcomes in prosthetic orbital restoration.
Our goal is to achieve what we have termed Visual Integration of the orbital prosthesis.
Some wear a larger orbital restoration we sometimes refer to as an upper facial prosthesis or a hemifacial prosthesis. These larger versions all include the prosthetic eye (ocular prosthesis), but they also may include the eyebrow or the nose or the cheek area. Knowing this, is the extent of the prosthetic restoration readily obvious? At a glance, would you even detect that the individual wears an orbital prosthesis? If the answer is no, then the wearer can interact confidently knowing they have the most convincing and accurate restoration possible. This accomplishment we call successful visual integration of the prosthesis.
All patients are encouraged to select attractive eyewear for protecting the sighted eye and to enhance the overall effect of the restoration. Glasses, even safety glasses as demonstrated by some in these examples very effectively cast shadows and refract light to obscure transitions and soften the fixed gaze of the eye.
The other main factor in considering what contributes to success in orbital prosthetics is how effectively the prosthesis attaches – not just how secure it is, but how easy it is to position, to remove and to care for without undue concern about damaging the exquisite detail instilled in the prosthesis. An orbital prosthesis that is attractive, durable AND manageable by the patient such that it used each day in the patient’s routine has achieved what Medical Art Prosthetics has termed Functional Integration.