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What is an Ocular Prosthesis (Artificial Eye)?

An ocular prosthesis is an artificial eye that ocularists implant in patients who have lost eyes or have eye abnormalities due to several reasons that include but are not limited to, the following:

  • Trauma
  • Surgery
  • Cancer
  • Shrunken damaged eyes (Phthisical Eyes)
  • Congenital absence (Anophthalmos)
  • Abnormally small-sized eyes that don’t have visual potential (Microphthalmos)

These physical defects and disfigurements impact patients’ physical function and can also take a toll on them psychologically. While artificial eyes cannot enhance or restore a patient’s field of view like human retinas, an ocular prosthesis can help to boost their confidence by improving their appearance.

There are different kinds of artificial eyes, too. Here are a few options that may be available:

  1. Scleral Shells — Scleral shells are made of a thin and transparent hard plastic material with a central dark-colored disc of paint that is meant to resemble the iris. Scleral shells are worn over the shrunken or disfigured eye and cover the entire front of the eyeball. They can disguise an opacified cornea and other visible abnormalities.
  2. Stock Shells — Stock shells are readymade acrylic shells that are available in standard sizes and shapes. An ocularist will fit them in patients with moderately shrunken eyeballs and in newborns and children with congenital absence (anophthalmos) abnormally small eyes (microphthalmos). Because stock shells are readymade, they do not always accurately match the color of the patient’s natural eye.
  3. Custom-Made Prosthesis: Custom-made artificial eyes are made of high-quality acrylic material that accurately fits into the patient’s eye socket with excellent symmetry. They are also hand-painted to perfectly match the correct color of the other real eye.

Patients may experience some discomfort until they get adjusted to the ocular prosthesis, whichever option they choose.


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How Does an Artificial Eye Work?

Every candidate will see an ocularist who can create a custom-made prosthesis after their socket wound has healed from surgery. Postoperatively, a surgeon will place a transparent conformer in the eye socket in place of the prosthetic shell, which the ocularist will first remove. 

Using an alginate, the ocularist will make a silicone impression model of the socket, which is then fabricated to create a white acrylic prosthesis. From there, the iris is painted in accordance to the patient’s natural eye color and pattern. The entire eye shell will be polished smooth and coated with a clear acrylic once more.

Once the artificial eye is ready, it will fit behind the upper and lower lid over the shrunken eyeball or orbital implant that’s placed after the surgeon removes the actual human eye.

For all types of artificial eyes, adequate eye care and maintenance is necessary. 

  1. Keep the artificial eye clean. Typically, patients can remove the shell once a month to wash it with soap and water, dry it, and refit it themselves. Patients should receive a plunger for easy removal and fitting of the prosthesis. But removing it too often could lead to watering, discharge, eyelid laxity and eversion, and discomfort.
  2. Lubricate the artificial eye. Patients could use a lubricant to smooth the surface of the shell and wash off debris on the shell surface.
  3. Polish the artificial eye. On a regular basis, the doctor will polish the prosthesis to ensure smooth surfaces and rounded edges. This prevents inflammatory reactions such as socket granuloma formations and giant papillary reactions. Your doctor may recommend that you polish it yearly or even once every four to six months.
  4. Change the prosthesis. Artificial eyes will last about five years. Renewing them to keep them clean, comfortable, and well-fitting is key.

Who is a Candidate for an Artificial Eye?

Candidates for artificial eyes include those who have lost an eye or who live with an eye abnormality. Often, patients who’ve had trauma to the face or cancer that affects the eyes (or surgery to remove cancer) are candidates for ocular prosthesis. Anyone with developmental eye issues such as shrunken or abnormally small eyes that do not function properly are also good candidates for artificial eyes.

Can You See With an Artificial Eye?

No, you cannot see with an artificial eye. But, while an artificial eye does not provide eyesight, it can boost a patient's confidence by improving their external appearance. Patients can still move the artificial eye (though not as much as a human eye), and they can fully blink the eyelids over the artificial eye.

That said, for the first time in history, scientists at the Hong Kong University of Science and Technology are exploring a bionic eye — the world’s first 3D artificial eye with capabilities that exceed human eyes. This electrochemical eye could give humanoid robots vision and provide hope for patients with various visual impairments. 

How Long Does a Prosthetic Eye Last?

Prosthetic eyes should last about five years and, while they may last longer, it’s wise to change them anyway. The eye socket will change shape over time, as does the iris and sclera color. Some doctors recommend changing prosthetic eyes every three years because of bodily changes. For children, they may need to be replaced even more often.

The color of the ocular prosthesis can change over time due to handling and sunlight exposure. Of course, proper eye care can add life to the biomimetic eye. Cleaning it and having it polished up every so often can help it to last longer. This is because the body’s proteins can eat into the top layer of the acrylic. While this happens on a nanoscale, it’s enough to dull down the glisten over time. As this happens, the eye looks less and less realistic.

How Much is an Artificial Eye?

A prosthetic eye's cost will vary depending on the patient’s needs and their choice of the prosthetic eye. Some vision insurance plans may cover artificial eye care.

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Author: AnnaMarie Houlis | UPDATED January 20, 2021
Medical reviewer: Dr. Melody Huang, O.D.
Resources

“Frequently Asked Questions.” Oculus Prosthetics, 5 Apr. 2019, www.oculusprosthetics.com/faq/

Ocular Prosthesis, www.sankaranethralaya.org/patient-care-ocular-prosthesis.html

Sajjad, Arbaz. “Ocular Prosthesis - A Simulation of Human Anatomy: A Literature Review.” Cureus, 6 Dec. 2012, www.cureus.com/articles/1356-ocular-prosthesis---a-simulation-of-human-anatomy-a-literature-review

Sethi, Tania, et al. “Fabrication of a Custom Ocular Prosthesis.” Middle East African Journal of Ophthalmology, Medknow Publications & Media Pvt Ltd, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4123284/

“World's First Spherical Artificial Eye Has 3D Retina.” ScienceDaily, ScienceDaily, 10 June 2020, www.sciencedaily.com/releases/2020/06/200610102726.htm.

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