What material is used in making the eye?

They are made using dimensionally stable, medical quality PMMA (Acrylic). This is the same material used in some hip replacements (and related procedures) and the material is compatible with being surgically inserted into the body, therefore allergies to the material are highly unlikely.

How long have artificial eyes been around?

Artificial eye-making has been practiced since ancient times. The first ocular prostheses were made by Roman and Egyptian priests as early as the fifth century B.C. In those days, artificial eyes were made of painted clay attached to cloth and worn outside the socket.

It took many centuries for the first in-socket artificial eyes to be developed. At first, these were made of gold with colored enamel. Then, in the later part of the sixteenth century, the Venetians started making artificial eyes out of glass. These early glass eyes were crude, uncomfortable to wear, and very fragile. Even so, the Venetians continued making them and kept their methods secret until the end of the eighteenth century. After that, the center for artificial eye making shifted to Paris for a time; but by the mid-nineteenth century, German glass blowers had developed superior techniques, and the center for glass eye making moved to Germany Shortly thereafter, glass eye making was introduced in the United States.

During World War II, the imported German glass used for glass prostheses became unavailable in this country. As a result of this shortage, the U.S. Government, in conjunction with a number of American firms, popularized the techniques for making artificial eyes out of acrylic plastic. The popularity of this method has continued to increase over the years, and today the vast majority of patients wear ocular prostheses made of acrylic.

What is the difference between a Stock eye and custom made one ?

Stockor ready-made ocular prostheses are mass-produced. Since a, stock eye is not made for any particular person, it doesnot fit any particular patient.

A customocular prosthesis, on the other hand, is made by your ocularist to fit you and you alone.How many appointments are required to obtain prosthesis?In order for prosthesis to successfully create the illusion of life and fit correctly and comfortably, all details must be sensitively replicated. The process requires several patient visits as well as extensive laboratory work. Typically, three to five appointments are needed to complete a custom-designed prosthesis. The appointments vary from one to four hours depending on the procedures being performed. Other facial prostheses incorporate the latest technology and are retained by magnets or clips, which connect to bone-anchored implants. Candidates for this treatment must first undergo surgery to place the implants.

How are prostheses attached?

Medical adhesives and tapes are common means of attachment. Most finger prostheses are suction retained and do not require adhesive.

How will I adjust to wearing prosthesis?

Becoming accustomed to your prosthesis will take time and a positive attitude. Patients who seem most satisfied with their prostheses tell us that its greatest benefit is that it helps them feel inconspicuous in crowds. Because everyone has different perceptions of what prosthesis can do for them, we cannot guarantee that your expectations will be met. Our clinical staff encourages you to openly discuss any concerns you may have in adjusting to your new prosthesis. We can also arrange for you to speak with one of our patients who wear prosthesis.

How often do you have to see an ocularist?

The ocular prosthesis, like hard contact lenses, needs to be polished regularly in order to restore the acrylic finish and insure the health of the surrounding tissues. It is generally recommended that infants under 3 years of age be seen every 3 months; patients under 9 twice yearly, and all other patients at least once a year.

What is the American Society of Ocularists?

The American Society of Ocularists (ASO) is a professional organization, which was established by a group of skilled American ocularists in 1957. Their purpose was to promote high standards through research and education in the field of ophthalmic prosthetics. Today the ASO maintains quality ocularistry through its formal education, training and continuing education 4programs.How do I find a good ocularist?In most states, there are no laws governing ocularists. When choosing an artificial eye maker, you should consult your state regulations and look for the following credentials:Membership in the American Society of OcularistsCertification by the National Examining Board of Ocularists

What will I look like following surgery? Will I have a hole where my eye was?

With the eyelids closed, your appearance will be unchanged. When your lids are open, you will see conjunctiva covered by a conformer. Conjunctiva is the pink tissue resembling the mucous membrane inside your mouth. This tissue covers the ball implant, which has been implanted in the socket, filling the space created by removal of the eye.

What is the conformer,  What do I do if the conformer comes out?

The conformer is a triangular-shaped plastic shell with a central hole and an apex and a base. It will keep the shape of your eyelids until you get your prosthesis. If the conformer does come out, you can put it back in. First wash the conformer under running water. Then point the apex towards the nose, slide the conformer under the upper lid, pull down the lower lid and blink. The conformer will go back into place.

When will I get my prosthesis?

In two to six weeks after your surgery you will be fitted with a temporary prosthesis at the ocularist's office. On your second visit, approximately three weeks later, you will be fitted and receive your permanent prosthesis.

Will my prosthesis look like my other eye?

Yes, the prosthesis looks very natural. The color and appearance are made to match your other eye. The pupil will be of normal size, but will not grow larger and smaller in response to light as it does in the normal eye.If you have received a hydroxyapatite orbital implant the prosthesis will also be able to move in conjunction with your other eye.

What will I wear between going home and getting my prosthesis?

The conformer will remain in place under the lids. An eye patch will cover the eye. Dark glasses may also be worn.

Will I be able to do everything I did before?

Yes, although you will have to make a few adjustments. You will not have good depth perception or have a full binocular field of peripheral vision.

What special adjustments will I have to make?

Use head movements as fully as possible to compensate for the lack of depth perception and decreased peripheral vision. You have to develop a habit of looking around before you. Learn to use your nose as a pointer.

Do I need to wear eyeglasses?

Your doctor may advise you to wear glasses as an added protection for your good eye.

May I wear makeup?

Yes.

Will I be able to drive?

Yes, you can learn or continue to drive. Licensing standards vary from state to state; however, all 50 states and the District of Columbia license drivers with one eye who pass their eye test.

May I go swimming?

Yes, you may go swimming, although goggles or a mask are a good idea. If water skiing or diving, remove your prosthesis first, since it may become dislodged on impact.

Is it normal to have mucous or other discharge?

Yes, most people experience a normal amount of mucous discharge. If the amount increases or changes in color, consistency or develops an odor, then you need to see your ophthalmologist right away to check for any signs of infection.

What kind of results can I expect?

Results vary from person to person and are dependent on factors such as age, type of surgery/implant, and general condition of the eye socket. See examples of actual patient results for a general idea of optimal results, however please discuss your anticipated results with the ocularist at your visit.

Care and preservation of prosthesis?

Artificial eyes are made out of material that will dissolve if it comes in contact with alcohol or any chemical product containing alcohol. The proper way of cleaning the eye is simply with warm water and soap. Some users prefer to soak the eye in saline cleaning solution (similar to that used for contact solution) although if you experience significant protein buildup, you should see your Ocularist for cleaning/polishing.

How can I achieve movement of the prosthesis?

Movement is achieved using implants that are surgically implanted by your opthalmologist. Some movement is possible depending on the condition of the socket. Read more about porous implants or discuss this with your ocularist.

When should I use an eye patch?

You should use an eye patch as directed by your opthalmologist or if you wish to conceal your socket until your prosthesis is fitted.

Will people notice that I have an artificial eye?

Patient results vary from case to case, however many people have artificial eyes and successfully conceal this from the public (and in some cases, even from close family and friends!) Please share any concerns you have regarding the results of your prosthesis with your ocularist.

What is the youngest a child can be fitted?

Patients as young as 6 months of age have been fitted with prosthesis. It is important that infants and children be evaluated by the ophthalmologist and referred to have an artificial eye made. If children are not fit with an eye and do require them, facial asymmetry can result as the child grows and develops.

What is a scleral shell?

A scleral shell is similar to an artificial eye with the difference being the depth of the posterior (back part). A shell covers the eye that has not had a full enucleation (removal of the eye) and can be used with Phtisical eye patients or those that have had injuries. Your ophthalmologist will refer you to have the proper item fit.

What information should my family and friends know?

(in case of emergency or loss of the eye)Anyone who may come in contact with the prosthesis should know not to place it in rubbing alcohol or related products.

What do I do if I have irritation, swelling, or pain?

If you are experiencing pain that is related to the prosthesis, please contact your Ocularist immediately. If you are experiencing general irritation, discharge, and discomfort with your eye socket please contact your ophthalmologist immediately.

What will I look like after the operation?

After the operation, when the eyelid is lifted, the conjunctiva is visible, a tissue similar to the mucosa, which lines the mouth inside. The conjunctiva lines the eyelids and eye cavity even after the eye is removed. Of course, the patient is sent to the prosthetist with a bandage covering the operated area. Enucleation is certainly a very serious operation, but it is possible today to act immediately by applying an ocular prosthesis or at least a conformer.

What is a conformer?

A conformer is a protective shell made of acrylic material, which, at the surgeon's discretion, is applied after the operation and is meant to keep the cavity size unchanged which would otherwise atrophize rapidly. If the conformer should come out of the cavity accidentally, it can be refitted immediately without any problem after carefully washing it with a physiological solution like that used for contact lenses. If your surgeon decides to avoid fitting a conformer, the functionality of the eyelids and size of the cavity are not affected: however, it must be borne in mind that the time for fitting the first ocular prosthesis is considerably shortened.When can I have the prosthesis fitted?Immediately after the operation, as said earlier, a conformer or temporary prosthesis will be fitted to allow the tissues to adapt during the healing of the cavity. After about 15 to 20 days, the first ocular prosthesis will be fitted, which will satisfy the aesthetic requirements but must be gradually modified during the period of settling into the cavity (two to three months, on average).

Will the prosthesis be like the other eye?

The appearance of the prosthesis is very natural: its colour and shape are exactly identical to that of the other eye. The pupil will be average sized and will not contract or expand in response to the light intensity. The eye movements will however be very similar to those of the other eye and limitations will occur in the presence of obstacles like scars or special tissue tightness inside the cavity.

Is the application of prosthesis painful?

In adults, or co-operative subjects, the fitting is not at all painful: however, there may be a slight sense of irritation, especially during the initial temporary phase, or when the shape of the prosthesis has to be modified considerably.

Will I be able to move freely as I did before the operation?

Certainly, but remember that the prosthesis is a foreign body and must be respected as such by following the instructions for use and maintenance. Using the prosthesis while practicing sport and diving is possible and almost free of limitations. Apart from this, it will also be necessary to get used to the different perceptions of distance and narrowing of the field of vision: therefore, short movements of the head must be made to compensate for the loss of perception of distance and field of vision, using the nose as the of reference.

What other visual limitations must I get used to?

Monocular vision produces total loss of the so-called field depth. In other words, during the first few days, with monocular vision, there is considerable difficulty in estimating the correct position of objects right in front of you because of lack of stereoscopic vision (a classic example is that of being unable to take the salt on the table at the first attempt.). This phenomenon lasts from a few days to a few weeks and tends to disappear gradually, automatically, as new visual information begins to reach the brain and is processed.

Will I have to use sight or safety glasses?

It is not strictly necessary. If you do not suffer from sight defects, you can in any case use safety glasses because, in certain cases, the ocular region subjected to such extensive surgery will easily be affected by the action of atmospheric and environmental agents like wind and dust. If the healthy eye suffers from ametropia (myopia, hypermetropia, etc.), it is good practice to prescribe glasses with two lenses having identical characteristics so that the prosthesis resembles the other eye as far as possible.

Can I use makeup?

Certainly. It is advisable to use hypoallergenic products.

Can I drive?

You'll have to learn to drive taking into consideration the new type of monocular vision; otherwise there are no limitations. Your driving license will have to be modified to suit your new condition.

Are eye secretions normal even with prosthesis?

Yes, it is quite normal. Even in the presence of a prosthesis, the ocular cavity will continue to react like it did before the operation: the secretions of the lachrymal and palpebral glands will have to be cleaned using the hygienic procedure explained to you by your ocularist.

Should I lubricate my prosthesis?

Not all wearers will need to lubricate their artificial eye, especially children. However, if one is not able to fully close their eyelids over the prosthesis, the use of artificial tears or other lubricants may be indicated. The need for lubricants varies with each individual.Your Ocularist or Ophthalmologist will make recommendations regarding the use of lubricants.

Will I have to use sight or safety glasses?

It is not strictly necessary. If you do not suffer from sight defects, you can in any case use safety glasses because, in certain cases, the ocular region subjected to such extensive surgery will easily be affected by the action of atmospheric and environmental agents like wind and dust. If the healthy eye suffers from ametropia (myopia, hypermetropia, etc.), it is good practice to prescribe glasses with two lenses having identical characteristics so that the prosthesis resembles the other eye as far as possible.

Can I use makeup?

Certainly. It is advisable to use hypoallergenic products.

Can I drive?

You'll have to learn to drive taking into consideration the new type of monocular vision; otherwise there are no limitations. Your driving license will have to be modified to suit your new condition.

Are eye secretions normal even with prosthesis?

Yes, it is quite normal. Even in the presence of a prosthesis, the ocular cavity will continue to react like it did before the operation: the secretions of the lachrymal and palpebral glands will have to be cleaned using the hygienic procedure explained to you by your ocularist.

How often should I remove my prosthesis?

In the case of enucleation, routine removal of an ocular prosthesis is not recommended. As long as the prosthesis remains comfortable, it should not be removed. However, the prosthesis may accumulate residual mucous secretion deposits on its surface. These deposits warrant removal and cleaning. After following the recommended cleaning procedure, reinsert the prosthesis.It is important to minimize the frequency of removal. This seems to result in fewer problems with mucous discharge. Most people are able to keep the prosthesis in place until the next scheduled visit with the Ocularist. This can be for as long as six months. Your Ocularist and Ophthalmologist will help you decide an appropriate care plan.

Will I be able to play sports while wearing an ocular prosthesis?

Wearing prosthesis should not limit your involvement in almost any sport. However, when possible, sport-specific safety goggles should be worn.When swimming it is important to either keep your eyelids closed when underwater or wear swim goggles.

Should I wear protective eyewear?

It is strongly recommended that one wear a pair of spectacles with polycarbonate (shatter proof) lenses. Even if no visual correction is required in the other eye, these safety spectacles will provide protection to the remaining eye in the event of a facial injury.

Will the socket still have normal tear flow?

Enucleation will not effect the basic function of the orbit's lacrimal gland, which produces tears. However, the eye socket is naturally lined with mucous membrane, similar to the inside of your mouth, which produces much fluid.The prosthesis is a hard non-absorbing acrylic that doesn't hold the lubrication very easily. This combination of factors can sometimes cause an over flow of tears, especially in children.Tearing and mucous is greatly effected by environment. A day at the beach or at the baseball field may cause excess tearing from the eye socket being irritated. This can be managed with irrigation and lubricating drops. It is also normal for one to experience an increase of mucous discharge when suffering from a cold or flu.

Will the prosthesis move with the other eye?

In most case the prosthetic eye will move because the Ophthalmologist constructs the eye socket in a method, which transfers movement to the artificial eye. This is done by placing an ocular implant into the eye socket upon the time of surgery.The implant is placed into the muscle cone, and therefore replaces some of the volume lost by surgical removal of the eye. During surgery, the Ophthalmologist attaches the eye muscles to this implant. It is then covered with a layer of natural conjunctival tissue. The prosthesis is fit over the implant and the movement of the implant is transferred to the prosthesis.