Name of the Procedure:

Common Name: Prosthetic Eye Fitting
Technical/Medical Term: Ophthalmic Prosthesis (HCPCS V2629)

Summary

A prosthetic eye fitting involves the customization and placement of an artificial eye. This procedure replaces a natural eye that has been removed due to injury, disease, or congenital conditions, aiming to restore both cosmetic appearance and some level of eye functionality.

Purpose

Medical Conditions Addressed:

• Loss of an eye due to trauma or injury
• Eye removal due to cancer or severe infection (e.g., retinoblastoma, ocular melanoma)
• Congenital absence of an eye (anophthalmia)

Goals/Expected Outcomes:

• Improve facial symmetry and aesthetic appearance
• Enhance the person’s confidence and psychological well-being
• Provide a stable and comfortable fit to protect the eye socket

Indications

Symptoms/Conditions:

• Absence of an eye
• Significant disfigurement of an eye that impacts quality of life

Patient Criteria:

• Individuals who have undergone an enucleation, evisceration, or exenteration
• Patients with one natural eye who have lost function or appearance of the other

Preparation

Pre-Procedure Instructions:

• No specific fasting required
• Patients may need to stop certain medications as directed by their healthcare provider
• Discuss with the ocularist any allergies, especially to materials used in the prosthesis

Diagnostic Tests/Assessments:

• Evaluation of the eye socket by an ophthalmologist
• Measurement of the eye socket to ensure proper prosthesis fit

Procedure Description

1. Initial Consultation: Assessment of eye socket and discussion of patient’s needs.
2. Impression Taking: A mold of the eye socket is created using a soft material.
3. Model Creation: A wax model of the prosthetic eye is crafted and modified for fit and comfort.
4. Fitting Session: The model is tested in the patient’s eye socket and adjustments are made.
5. Final Prosthesis Creation: The final prosthetic eye is fabricated using durable, biocompatible materials.
6. Final Fitting: The prosthetic eye is placed and fine-tuned for optimal appearance and comfort.

Tools/Equipment:

• Impression materials, wax for modeling, and customized ocular prosthetic materials
• Polishing and adjustment tools

Anesthesia/Sedation:

• Typically, no anesthesia is needed. If the patient is anxious, mild sedation may be considered.

Duration

• The entire fitting and customization process may take several weeks, with multiple short sessions (1–2 hours each).

Setting

• Outpatient clinic specializing in ocular prosthetics

Personnel

• Ocularist (a specialist in making and fitting prosthetic eyes)
• Ophthalmologist (for initial assessment and follow-up care)
• Nursing staff for assistance

Risks and Complications

Common Risks:

• Discomfort or irritation
• Inflammation of the eye socket

Rare Risks:

• Infection
• Allergic reaction to materials used

Management of Complications:

• Use of antibiotic or anti-inflammatory medications
• Adjustment of the prosthetic eye for better fit

Benefits

Expected Benefits:

• Improved facial symmetry
• Enhanced psychological well-being
• Restoration of natural appearance

Realization Time:

• Immediate improvement in appearance; emotional and psychological benefits can be felt within days to weeks.

Recovery

Post-Procedure Care:

• Regular cleaning and care of the prosthetic eye
• Use of lubricating drops to prevent dryness

Recovery Time:

• Minimal recovery; patient can resume normal activities almost immediately

Restrictions/Follow-Up:

• Regular follow-up appointments for adjustments as necessary

Alternatives

Other Treatment Options:

• Custom false eye patches
• Watchful waiting in non-cosmetic concerning cases

Pros/Cons:

• Alternatives Pros: Less invasive, lower cost
• Alternatives Cons: Do not provide the same cosmetic benefit or psychological relief

Patient Experience

During Procedure:

• Minimal discomfort during molding and fitting

After Procedure:

• Possible initial irritation as the eye adjusts
• Emotional relief and improved confidence
• Pain management typically not necessary, but over-the-counter options can be used if discomfort occurs.