Prosthetic eye rehabilitation and management of completely blind patients

Facial prostheses aim to restore the appearance, contours, and esthetics of the face while consequently enhancing patients' self-esteem and reintegration into social life. Restoring unilateral missing ocular and orbital tissues is a challenging task that requires great skill from the clinician (anaplastologist) to accurately mimic the opposing natural tissues. Bilateral defects present additional technical and clinical challenges for clinicians and patients alike. This article presents two cases involving restoration of the ocular and orbital components of bilaterally blind patients. The first case comprised the construction of indwelling scleral eye shells for both eyes, while the second comprised left orbital (implant-retained) and right indwelling eye shell prostheses. Custom-made bilaterally indwelling eyes are more esthetically pleasing than stock options and show better fit and comfort following conventional impression techniques. Clinical challenges include impression taking, prosthesis fabrication, identification of the correct orientation into the socket, communication with the patient, and satisfaction of patient expectations. Since both patients were blind, their families played a vital role in describing their prostheses and thus in improving the patients' self-esteem and satisfaction with treatment.