Maxillofacial esthetic rehabilitation using bilateral custom ocular prosthesis in a case of anophthalmia and phthisis bulbi

Abstract

Bilateral loss of the eyeballs is a condition that not only causes visual impairment but also significantly impacts the patient’s aesthetic appearance and psychosocial well-being. Rehabilitation through the fabrication of custom ocular prostheses can help restore facial appearance and patient self-confidence. This case report aims to describe the fabrication process and clinical outcomes of bilateral custom-made acrylic ocular prostheses in a patient with right-sided anophthalmia and left-sided phthisis bulbi. A 54-year-old male patient presented to the Prosthodontics Department at RSGM UNPAD, Bandung, with complaints of loose and uncomfortable right and left ocular prostheses. The patient had undergone enucleation of the left eye and had been wearing prostheses for the past five years. A new pair of custom ocular prostheses was planned. The treatment procedure included socket impression using polyvinyl siloxane (PVS), fabrication of a positive model, wax pattern try-in followed by acrylic sclera construction, manual iris painting, and application of clear acrylic as the final layer. The prostheses were inserted following a comprehensive evaluation of adaptation, retention, symmetry, and the psychological response of the patient and family. Custom ocular prostheses provide an effective rehabilitative solution for bilateral ocular loss. With an individually tailored design, they restore facial symmetry, enhance self-esteem, and reduce psychological distress.