CCA Ocular Prosthetics 2 — Questions and Answers
Question 1: Which layer of the ocular prosthesis is responsible for giving the iris its depth and three-dimensional appearance?
- The posterior acrylic button
- The hand-painted iris lamination between clear acrylic layers (Correct answer)
- The scleral wax backing
- The corneal dome overlay
Correct answer: The hand-painted iris lamination between clear acrylic layers
The hand-painted iris is laminated between layers of clear acrylic to create a realistic depth effect in the finished prosthesis.
Question 2: A patient presents with an anophthalmic socket that has developed ptosis of the upper eyelid. What is the most likely contributing prosthetic factor?
- Excessive prosthetic weight causing levator muscle stretch (Correct answer)
- An overly polished posterior surface
- Insufficient superior fornix depth on the prosthesis
- An incorrectly placed iris position
Correct answer: Excessive prosthetic weight causing levator muscle stretch
Excessive prosthetic weight can chronically stretch the levator muscle, contributing to acquired ptosis in anophthalmic patients.
Question 3: What is the purpose of the conformer placed in the socket immediately after enucleation?
- To provide immediate vision
- To maintain the conjunctival fornices and prevent socket contraction (Correct answer)
- To reduce post-operative bleeding
- To begin shaping the definitive prosthesis
Correct answer: To maintain the conjunctival fornices and prevent socket contraction
A conformer maintains the conjunctival fornices open and prevents socket contraction while the socket heals after enucleation.
Question 4: When modifying a stock ocular prosthesis for a pediatric patient, which growth-related consideration is most critical?
- Children require larger prostheses than adults from the outset
- The prosthesis must be replaced or modified frequently to stimulate orbital growth (Correct answer)
- Pediatric sockets do not require conformers
- Stock prostheses are never appropriate for children
Correct answer: The prosthesis must be replaced or modified frequently to stimulate orbital growth
Adequate orbital volume stimulation through prosthetic modifications is essential to promote normal orbital and facial bone development in children.
Question 5: Which suture technique is most commonly used to close the conjunctiva over an implant after enucleation?
- Running horizontal mattress
- Interrupted Vicryl sutures in a layered closure (Correct answer)
- Continuous silk suture
- Staple closure
Correct answer: Interrupted Vicryl sutures in a layered closure
A layered closure with interrupted absorbable Vicryl sutures provides secure wound closure over the orbital implant after enucleation.
Question 6: What is anophthalmic syndrome?
- Infection of the orbital socket following enucleation
- A complex of changes including enophthalmos, superior sulcus deformity, ptosis, and lower lid laxity in the prosthetic eye (Correct answer)
- An autoimmune reaction to implant materials
- Congenital absence of the eye with no orbital development
Correct answer: A complex of changes including enophthalmos, superior sulcus deformity, ptosis, and lower lid laxity in the prosthetic eye
Anophthalmic syndrome describes the constellation of orbital volume deficiency changes — superior sulcus deepening, ptosis, enophthalmos, and lower lid laxity — seen in long-term prosthetic eye wearers.
Question 7: When painting veins on an ocular prosthesis, red silk threads are commonly used. How are they typically secured?
- Glued to the anterior surface with cyanoacrylate
- Embedded in the acrylic during the final pour of scleral material (Correct answer)
- Painted on with acrylic paint after polishing
- Sewn through the prosthesis body
Correct answer: Embedded in the acrylic during the final pour of scleral material
Red silk threads are embedded within the acrylic scleral layer during fabrication to realistically simulate episcleral blood vessels.
CCA Ocular Prosthetics 2
Which layer of the ocular prosthesis is responsible for giving the iris its depth and three-dimensional appearance?