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Terminology and Definitions

A

Anophthalmic/Anophthalmos

Absence of an eye(s).  It can be a congenital (born without) or an acquired condition (surgically removed).

Acquired Condition

A condition that can be brought about by an eye disease, trauma or surgery resulting in phthisis, evisceration, enucleation orexenteration of the eye.

Adipose Tissue

Orbital fatty tissue that cushions the eyeball.  lt is usually made reference to when its loss, reduction or displacement within the orbit causes facial asymmetry of the eyelids resulting in enophthalmos and/or superior sulcus depression.

Adiposis

The breaking down of fatty tissue, or its gravitational displacement following loss of the eye.  It can also occur following trauma induced phthisis.

Adnexa

Appendages of the eyeball, which includes the eyelids, muscles and soft tissue.

Alginate

A powdery extract of marine kelp when mixed with water sets into a gelatinous form.  It is used to taking impressions of the orbit or globe.

Anterior Chamber

Area between the cornea and iris in both the human eye and the ocular prosthesis.

Anterior Surface

The front of the ocular prosthesis, implant and/or the eye.

Arcus Senilis

A white or creamy opacity around the edge of the cornea that is found in the aged.

Asymmetrical/Asymmetry

An imbalance in facial alignment as it relates to the eyes, eyelids or eyebrows.

Avascular Implant

A solid orbital implant that will not allow penetration of blood vessels.  It is usually encapsulated in fibrous tissue.

B

Bio-compatible Implant

A porous implant that can be infiltrated with living tissue.

Blepharal

Reference to the eyelids.

Blepharitis

Inflammation of the eyelid margin.

Blepharophimosis

An abnormally small eyelid aperture.

Blepharoplasty

A corrective surgical procedure of the eyelid.

Blepharoptosis

A drooping of the upper eyelid.

Blepharochalasis

Excessive relaxation of the eyelid caused by loss of muscle tone.

Buccal Mucosa

Tissue in the mouth that is used for split or full thickness grafts in reconstruction of the fornices.

Bulbar Conjunctiva

The tissue covering the scleral of the eyeball.


C
Canthi (plural)

The juncture where the upper and lower eyelids meet.

Canthus

Reference to either the medial (inner) and the lateral (outer) extent of the eyelids.

Catoptric Image

A reflective light image cast upon the cornea of the human eye and the ocular prosthesis.  A balanced reflective image on the corneas would signify symmetrical alignment.

Chemosis

A severe swelling of the bulbar conjunctiva.

Cilia (plural: Cilium)

The eyelashes.

Clinical Anophthalmos

Birth defect: Complete absence of an optic vesicle (eye).

Conformer, Plastic/Silicone

A concave oval shape piece placed into the socket following surgical removal of the eye.  It aids in retention of the upper and lower cul-de-sac, and to prevent inversion of the eyelashes.  It also has two small holes to allow drainage of secretion and to apply post-operative antibiotics.

Conformer, Custom Plastic

A specific peripheral contour, anterior curvature and thickness.  It will also have a specific thickness in order to preserve or expand the culs-de-sac.

Conformer, Pressure Stem

The application of external force by means of an attached 'mushroom' shaped stem.  Used when the anophthalmic cavity is unable to retain a prosthesis.  Also, used to expand the orbital tissue and palpebral fissure.

Congenital Anomaly

An abnormal condition that affected the complete development of the eyeball(s).

Conjunctiva

The mucous membrane tissue which lines the under part of the eyelid (palpebral) and the eyeball (bulbar).

Conjunctival Flap

A portion of superior bulbar conjunctiva is drawn over the cornea and sutured to the inferior bulbar conjunctiva.

Cornea

The clear curved surface of the eye and prosthesis.  Its anterior chamber depth can highlight the pigments in the iris.

Crazing

Stress fractures in the plastic that can be caused by improper curing or a chemical reaction from a non-compatible substance (alcohol).

Cosmesis

Mirror image symmetry of the eye and lids.  A return to a normal appearance.

Cul-de-sac  (Plural: Culs-de-sac)

The shallow pocket where palpebral and bulbar conjunctiva meet in the lower eyelid, and the deeper recess in the upper eyelid.  See: Fornix

Custom Plastic Conformer

See Conformer, Custom Plastic


D

Debulk

To drastically reduce in size, decrease the amount of mass.

Dehiscence

A splitting or gaping of the conjunctiva at a suture line or exposure of an implant.

Delamination

The splitting apart or separation of layers, usually in the painted iris, when pigments used are incompatible to the acrylic.

Dermatochalasis

Excessive eyelid skin caused by loss of its elasticity.

Dermis Fat

Autogenous tissue used to implant within the anophthalmic cavity for reduction of enophthalmos.

Dry Eye Syndrome

A deficiency in tear film components (tears, mucus).

Dysfunction

Impaired action of the orbits extraocular and/or eyelid muscles causing a lack of synchronized eye/prosthesis movement and/or asymmetrical eyelid opening.

Dysfunctional Globe

An impairment of function, possible loss of vision, disfigured globe.


E

Ectropion

The turning outward of the eyelashes and eyelid.

Ectropion (of the upper eyelid) is accompanied with retrotarsal atrophy.

Ectropion (of the lower eyelid) is caused by orbicularis muscle weakness, and/or prolapse of adipose tissue.

Edema

An excessive amount of fluid in the subcutaneous tissues.

Embryonic Stage

A state of being an embryo, underdeveloped, rudimentary.

Empirical Fit

A trial and error method of fitting preformed shapes in order to make a custom made prosthesis.

Enophthalmos

The overall 'sinking in' appearance following loss of the eyeball, or partial loss of ocular volume.

Entropion

The inward turning of the eyelashes and eyelid.  This is usually accompanied by contraction of the palpebral conjunctiva (under part of the eyelid).

Enucleation

The complete removal of the eyeball.

Epiphora

An overflow of tears.

Evisceration

Complete removal of the contents of the eye, this could include the cornea.

Eye Fitter

An ancillary eye care provider who does not fabricate, but does fit stock prostheses.

Exenteration

The removal of the orbital contents which could include the eyelids.

Exophthalmos

Abnormal protrusion of the eyeball.

Extrusion

An expulsion of an orbital implant.


F

Fenestrated

Having many small holes (to allow excess impression gel to flow through).

Fibrovascular

Ingrowth infiltration of blood vessels and fibrous tissue.  A means of stabilizing/anchoring a porous type implant.

Fornix (Plural: Fornices)

Inter-related to cul-de-sac.  It is the peripheral extreme where palpebral and bulbar tissues meet in the enucleated cavity.


G

Geriatric Cases

The older patient with an atonal condition of the external orbital tissue and muscles.


I
Implant
Any inert foreign or autogenous material embedded within the living tissue in the orbit. 

Impression Moulding Technique

An adapted version from the dental profession for obtaining an accurate copy of the anophthalmic socket, and/or affected eye with a suitable impression tray.

Impression Tray

An acrylic scleral shell with multiple fenestration's and an attached tube for injection of an alginate impression gel.  The excess gel will flow through the holes.  Once set the gel and tray can be removed as a unit.

Integrated

Associated with moveable ocular implants: Attachment of the recti (eye muscles) to the implant.

Iris

The colored diaphragm of the eyeball with a dilating pupil. It makes up the whole character of the eye.


L

Lacrimal Duct

The tear ducts remove the tears as they flow toward the inner canthus.  Excessive tearing or blockage of the ducts will cause the tears to flow down the cheek.

Lacrimal Gland

Located in the upper and outer posterior part of the eyelid, that secretes tears when you blink.

Lagophthalmos

Voluntary or involuntary (incomplete) closure of the eyelid.

Levator Muscle

It controls the elevation of the upper eyelid.

Limbus

The boundary between the cornea and scleral.


M
Macrophthalmos

An abnormally large eyeball, usually related to infantile glaucoma.

Maxillofacial Prosthesis

A term describing an external/orbital prosthesis (Lids and Eye).

Meibomian Glands

Pores in the eyelids that secrete an oily substance to prevent your normal tear flow from running down your cheek.

Microphthalmic/Microphthalmos

A congenital anomaly (abnormal development).  Partially developed eyeball(s).

Mold

A form or die plate made from any preformed or custom moulded model that will later be reproduced.

Monocular

Singular vision.

Mould

Is a specific term applied to the action of taking an impression (mould) of the cavity or dysfunctional globe.

Mucous

A viscid secretion derived from the mucous membrane.


N

Nanophthalmos

Abnormally small eye with proportionately small surrounding eye structure.  (Congenital Anomaly)

Necrosis

The wasting away of tissue due to insufficient blood supply.

Non-surgical 'Cure'

Ability to restore a normal appearance by means of an eye prosthesis without requiring an oculoplastic procedure.

O

Ocularist

A person who fabricates and fits custom made artificial eyes.  The highest degree would be Board Certified Ocularist by NEBO.

Ophthalmoscopy

Visual examination of the eye.

Ophthalmologist

A medical physician (Oculist) who specializes in diseases and defects of the eye and its adnexa.  Performs medical and surgical treatment of these conditions.

Optician

A professional in the manufacturing of eye glasses and contact lenses.

Optometrist

A professional who examines the eyes and related structures for visual problems and disorders, prescribes glasses, lenses and other optical aids.

Orbicularis Muscle

The muscle that circles the eyelid.  Its function is to close the eyelids.


P
 

Palpebral Conjunctiva

The posterior (under part) of the eyelid tissue.

Palpebral Fissure

The eyelid opening, the aperture.

Photophobia

Abnormally sensitive to light.

Phthisis/Phthisical

Phthisis and Phthisical refers to an eye that has shrunk down due to loss of its fluid.  This is an acquired condition that is caused by a disease, trauma or possibly surgery.  (Acquired condition would indicate that you had a normal size eye prior to this event.)  Also, if the globe is Microphthalmic, it would indicate that it is a congenital problem.  It never developed to full size.

Plastic Conformer

See Conformer, Plastic/Silicone

Polymerization

The curing (with heat) of the raw acrylic (monomer and polymer) and forming a polymeric compound.

Polymethylmethacrylate (PMMA)

Acrylic (plastic) with Trade Names of Lucite and Plexiglas.

Porous Implant

 An implant having openings throughout to allow fibrous tissue ingrowth.

Posterior Surface

The back of the prosthesis or under part of the eyelid.

Pressure Necrosis

The localized wearing away of conjunctival tissue due to pressure from a poorly fitted prosthesis.

Pressure Stem Conformer

See Conformer, Pressure Stem

Preventative Maintenance

A periodic evaluation of the orbital contents, and reglaze of the plastic ocular prosthesis.

Primordium

An organ (eye) in its earliest stage of development.

Prolapse

Falling down of the lower eyelid (an atonal condition).

Protein Deposits

Dried tears, mucous, secretion build up on the surface of the prosthesis.  It can be abrasive causing irritation to the conjunctival tissues.

Proptosis

Protrusion of the eye.

Pseudoptosis

A sagging or drooping of the upper eyelid.  This is a result of orbital or global volume loss, but returns to normal elevation with a proper fitting ocular or scleral prosthesis.

Ptosis

Eyelid droop, caused by partial or complete loss of external orbital muscles.  It is usually referring to the upper lid (UP).  Lower lid (LL) would be a considered a prolapsed condition.

Psychological 'Cure'

Ability to restore cosmesis, to regain a normal appearance with the use of an ocular prosthesis or scleral shell.  Being accepted by your peers as looking normal.


R

Rectus (Plural: Recti)

Singular and plural for the muscles attached to the eyeball.

Reform Prosthesis

A description for a vacuum formed hollow glass eye.  It also was used to describe the plastic stock eye.  Today’s terminology refers to an ocular prosthesis as compared to scleral shell prosthesis.

Retinoblastoma

A malignant tumor involving the retina, usually effecting children in the first three years of life.  It can be hereditary.

Retinopathy of Primaturity

A retinal disease (ROP) in premature infants usually caused by excessive oxygen during the first few weeks of life.

Retrotarsal Atrophy

The sinking in of the upper lid with loss or displacement of adipose tissue.

Retrolental Fibroplasia

A disease (RLF) first reported in 1942.  Now categorized as (ROP) See: Retinopathy of Prematurity.


S

Silicone Conformer

See Conformer, Plastic/Silicone

Silicone Prosthesis Remover

A solid silicone prosthesis remover is similar to a suction cup and only requires you to hold it and make flush contact with the prosthesis (squeezing is not required) to remove it from the eye socket.  It is for patients with arthritis, rheumatism or just stiffening of the finger joints and are unable to use a suction cup.

Striations

As referenced to the iris, it is the fine pigmented lines between the primary collarette (near the pupil) and the periphery of the diaphragm (limbus).

Suction Cup

A small rubber or silicone vacuum device used in insertion and/or removal of the prosthesis.  See also Silicone Prosthesis Remover.

Superior Sulcus Depression

A loss or displacement of adipose tissue in the upper eyelid.

Symblepharon

Adhesion(s) between the bulbar and the palpebral conjunctiva.


T

Therapeutic Scleral Shell (TSS)

scleral shell whose thickness will restore lid and facial symmetry.  Also see: Non-surgical 'Cure' and Psychological 'Cure.'

Trichiasis

An inward turning of the eyelashes.

Turtle Lid Syndrome

Complete loss of adipose tissue causing the thin upper eyelid to conform closely to the anterior contour of the prosthesis and bony orbital wall.

 

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