a. Loss of an eye, ear, nose, cheek, hand, foot, are examples of items replaced with removable custom-fabricated prostheses at Restoration Clinics. Facial and somato restorations are custom-fabricated, are usually composed of plastic and/or silicone, and are maintained by the beneficiary or guardian. The life span of the prosthesis is from 1 to 2 years, excluding anatomical changes. The life span of the plastic eye prostheses is 2 to 5 years; however, some individuals are able to wear them for a longer period of time without anatomical changes. As a general rule, patients need to have their ocular prosthesis replaced at least every 5 years. At least once a year, prosthetic eye polishing is required to reduce the risk of papillary conjunctivitis, which is very difficult to treat.
b. In cases where an item is unsatisfactory due to wear, the individual beneficiary's prosthesis needs to be examined, by appropriate Prosthetic staff or another medical professional designated as the examining expert, to determine if a replacement is required.
c. Ocular prostheses, facial restorations, craniofacial implants, and somato prostheses (to include all repairs) must be custom-fabricated for eligible beneficiaries, when prescribed by a Department of Veterans Affairs (VA) physician, and obtained using an Orthotic Laboratory Work Order (OWL) for the Restorations Laboratory. NOTE: Repairs may be initiated when determined necessary by a qualified anaplastologis or VA physician.
d. All restoration prostheses are custom-fabricated and must be delivered in person to the beneficiary after a final fitting by a qualified practitioner. The mailing of items is to be limited to prosthetic eyes that have been polished for persons who are unable to travel because of medical reasons, provided there is little chance of any complications.
e. When a VA Restorations Clinic is not available, all restoration services that are contracted out to a local vendor must be evaluated for compliance to VA standards of patient care and VHA Handbook 1173.11, Ocular Prostheses and Facial Restorations. NOTE: It is desirable for both VA Restoration clinicians and private contractors to have a professional certification.