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Ocular Prosthetics

When a person learns that it is necessary to have an eye removed, the news creates understandable concern about how this procedure will affect their life, their appearance, and their ability to function. Due to advances in the field, the loss of an eye no longer means the loss of natural appearance. We work with doctors and patients to develop a custom-made prosthesis that is both realistic and functional. Our personalized approach ensures symmetry and an exact color match, while delivering a comfortable, functional prosthesis.

Please remember that the quality and realism that is achieved flows from the ocularist's hand that created it. No two ocularists have the same technique; therefore, results will vary. Our goal is to create the most realistic, comfortable prosthetic for our patients.

Artificial Eyes

An ocular prosthesis—otherwise known as an artificial eye—is a plastic prosthesis used when an eye is enucleated or eviscerated (surgical removal of the eye).

Artificial Eyes
Please visit our Photo Gallery to see more examples of artificial eyes.

What to Expect After Surgery

Following enucleation or evisceration, the surgeon will likely place an orbital implant to recover some of the volume lost in the eye socket. The orbital implant is attached to the extraocular muscles, providing movement of the implant with the fellow eye. Typically, the better the movement of the implant, the better the motility of the artificial eye or scleral shell.

In most cases, a plastic piece called a conformer is placed in the socket following surgery and is worn in place of the prosthesis. It is placed to maintain orbit volume and to help form the cul-de-sacs (lid pockets) that will hold the prosthesis in place. The conformer should be left in at all times so that socket volume is not lost during the healing process. This also prevents shrinkage of the tissue and helps to prepare the socket for ocular prosthesis placement. Until the ocular prosthesis is fit, the upper eyelid can be droopy in appearance. Once in place, the prosthesis will help support the eyelid and allow the lids to open and close normally. For more information about surgical procedures, please click here to visit the American Ocularist Society website.

The ocular prosthesis is fit four to six weeks after surgery in order to allow for the eye socket tissues to heal adequately.

Scleral Shells
Please visit our Photo Gallery to see more examples of scleral shells.

Scleral Shells

A scleral shell fits over the existing scleral white surface of a blind, injured, or malformed eye. In these cases, the non-functioning eye is left within the eye socket and a prosthesis is molded to fit between the lids and the blind eye. The wearing time for a shell varies with each individual and imparts better eyelid function as well as a better appearance by closely resembling the remaining good eye, while leaving the affected eye in the socket. We strongly suggest that you consider leaving the affected eye in its socket if it is not causing you pain. You may discuss this option with your doctor.

Fabricating an Ocular Prosthesis

The process of designing and fabricating an ocular prosthesis requires multiple office visits, which may be lengthy, as well as numerous hours of laboratory work. The following steps will be necessary:

Step 1: The creation of a custom ocular prosthesis begins with an impression (mold) to duplicate the affected area (eye socket). The impression is made by injecting a molding agent into the socket. Once set, the mold is removed from the socket.

Step 2: From the mold, a wax model is made to try in the socket. Wax is used because it can be easily changed and carved or added to quickly. The goal is lid symmetry and movement of the wax model.

Step 3: Once this symmetry is achieved, the wax model is cast into a plaster mold and an acrylic duplicate is made.

Step 4: With the patient present in the lab, the future prosthesis is painted to match the fellow eye. The process continues until an exact color match is achieved.

Step 5: The prosthesis is polished to a high gloss.

Step 6: The prosthesis is delivered to the patient.

Fabricating An Ocular Prosthesis
Please visit our Photo Gallery to see more examples of ocular prosthesis.

Pediatric Fitting

At approximately four to six weeks following eye removal surgery, the fitting process begins with a consultation, which provides an opportunity for your child to become comfortable with us and give them a brief and simple explanation of what will be done during the visit.

It is common to expect three to four visits for the initial prosthesis. One-day service is usually not possible as it can often be too much for young patients as the appointments usually take longer than an adult fitting.

Once the prosthesis is completed, a follow up appointment is scheduled for one month, then return visits every three months. This schedule is mainly due to the child's growth and color change during the first years of life. It is often possible to enlarge your child's current prosthesis if only minor changes are required. This defers the need for a completely new prosthetic eye for at least some period of time.

Pediatric Fitting
Please visit our Photo Gallery to see more examples of pediatric fittings.

FAQs

Care of Ocular Prosthesis

Removal and Cleaning

At one time, all artificial eye wearers were told to remove and clean the prosthesis on a regular basis. It has since been learned that removal on a regular basis keeps the eye socket mildly irritated. Today's artificial eyes generally need less attention due to improved fitting and polishing techniques. Many people do not feel the need to remove their prosthesis between visits to their ocularist.

However, should you need to remove your prosthesis, removal and reinsertion is an easy process. Your ocularist can show you the correct method. If you do remove your artificial eye, be sure to thoroughly wash your hands first; this will reduce the risk of infection and irritation.

Removing your prosthesis

Cleaning your prosthesis

Reinserting your prosthesis

Note: It is not required to use a suction cup to remove nor to insert prosthesis.

Checkups

It is recommended that you return to our office every six months to have your prosthesis polished. Usually there is a significant build-up of salt and protein deposits with time. Polishing removes these potentially irritating deposits. We will also evaluate your prosthesis' fit and appearance. Sometimes a build-up or adjustment may be called for, due to subtle changes in the eye's socket tissue.

Eye Drops

A few artificial eye wearers experience “dry eye” due to lack of lubrication. In these cases, the ocularist will often recommend an aqueous lubricating solution such as artificial tears. In cases where the individual cannot close the eyelids all the way or the eyelids do not close during sleep, an oily lubricant may be recommended. We recommend and use a silicone lubricant called Ocu-Sil™, which can be obtained at www.ocu-sil.com.

Storing the Prosthesis

If the prosthesis must be left out of the socket overnight or longer for any reason, store it in water or in a contact lens soaking solution.

Other Points to Remember

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Precision Ocular Prosthetics | 2611 Westwood Dr, Suite A | Nashville, TN 37204-2709 | P: 615-361-0930 | Toll Free: 888-345-0930 | F: 615-467-7507