Overhauling the Anophthalmos due to Retinoblastoma in Pediatric Patient: A Case Report

The stock eye prostheses which were used earlier are simple, easy, and less time-consuming, but the discomfort and potential for bacterial infections due to water pockets and incorrect fit make them obsolete and pave the way for customized ocular prosthesis, which require longer laboratory time for its fabrication.Thus, the modified stock eye technique by Taicher et al. 5 in 1985 was a simple yet effective alternative to the uncomfortable stock and time-consuming custom ocular prostheses.This article reports a case of prosthetic rehabilitation with a modified stock eye for a 5-year-old patient with an enucleated left eyeball due to retinoblastoma. Materials a n d MethodsA 5-year-old patient presented in the outpatient Department of Pediatric and Preventive Dentistry with a chief complaint of unesthetic facial appearance due to a missing left eye (Fig. 1).The patient lost her eye due to enucleation of the eyeball invaded introductionThe eyes are the very first organs to be noticed in an individual.The absence of an eyeball has a great impact on a child's self-esteem and severely impedes the growth and development of the facial region.The various causes of a missing eyeball may be congenital, including agenesis, deformities or acquired, including malignancy, trauma, infection, etc. 1 Malignancy, especially retinoblastoma, is the most common cause where removal of the eyeball is indicated in pediatric patients. 2 The treatment mainly includes evisceration, enucleation, and exenteration depending upon severity or invasion, followed by rehabilitation with fixed (ocular implants) or removable (stock, modified stock, custom-made) ocular prostheses.The purpose of an ocular prosthesis is to preserve the anophthalmic space, partially reestablish the lachrymal position, prevent fluid accumulation, restore facial esthetics, promote the growth of the orbit, and boost the patient's self-esteem.As the child has been exposed to the surgery earlier, he/she is usually fearful of the hospital set-up, making the fabrication of the ocular prosthesis a challenging process.The prosthesis is recommended to be replaced every 18-24 months as the child grows in order to effectively stimulate the development of surrounding tissues and minimize abnormalities. 3 This validates the role of a pediatric dentist who understands a child's psychology and growth very precisely.According to a study conducted by Dahan), the instances of missing eyeballs in pediatric patients in the decreasing order of occurrence were as follows-retinoblastoma, trauma, microphthalmia, anophthalmia, endophthalmitis, congenital glaucoma, etc. 4 Retinoblastoma is highly prevalent in Asian countries, with India having the highest anticipated incidence of retinoblastoma in the world, with about 1,400 out of 8,000 new cases diagnosed annually in children below 5 years of age.In order to rehabilitate the enucleated eyeball to maintain the tissue integrity as well as promote orbital growth, it is important for a pediatric dentist to have a thorough knowledge of the selection and fabrication of the ocular prosthesis.