Terminology & Definitions

A

Anophthalmic/Anophthalmos: Absence of the 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 or exenteration 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

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 eyelids.

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.ExtrusionAn expulsion of an orbital implant.

I

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

Impression Molding 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.

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.

O

Ocularist: A paramedical technician 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 Prematurity: 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: Retinopathy of Prematurity, see above.

S

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.