Prosthetic Eye

What is a prosthetic eye?

Prosthetic eyes are a very common treatment option for someone who has lost an eye. People of all ages and genders are fitted for prosthetic eyes after they have an eye (or in some cases, both eyes) removed due to a traumatic eye injury, illness, or eye or facial malformation.

The purpose of a prosthetic eye is to create a balanced facial appearance and increase comfort in the eye socket where the eye is missing.

People have been making and wearing prosthetic eyes for millennia. Early prosthetic eyes were made of clay that was painted and attached to a piece of cloth. Many centuries later, people began making spherical prosthetic eyes from glass.

Today, prosthetic eyes are no longer glass spheres. Instead, a prosthetic eye includes a porous round implant that’s inserted into the eye socket and covered with eye tissue called the conjunctiva.

A thin, curved, glossy painted acrylic disk made to look like a natural eye — complete with an iris, pupil, white, and even blood vessels — is slipped onto the implant. The disk can be removed, cleaned, and replaced when needed.

If you need a prosthetic eye, you can purchase a “stock” or “ready-made” eye, which is mass-produced and doesn’t have a customized fit or colour. Or you can order a “customized” eye made just for you by a prosthetic eye-maker, known as an ocularist. A custom eye will have a better fit and a more natural colouring to match your remaining eye.

How much does prosthetic eye surgery cost?

Some medical insurance plans cover the costs of a prosthetic eye or at least part of the costs.

Without insurance, ocularists may charge 20,000 to 60,000 for an acrylic eye and implant. This excludes the cost of surgery needed to remove your eye, which may be necessary and can be costly without insurance.

Even with insurance, under most plans, you’ll be expected to pay a fee (co-payment) during each visit to your ocularist, surgeon, and doctor.

While the surgery itself doesn’t take much time, you may experience pain and nausea in the first 72 hours following surgery. People undergoing this procedure usually have a minimum two-night hospital stay and go home when they feel ready.

You can return to school or work after this point, but you must take care of your surgery dressing and return to the doctor two weeks later for removal of your stitches.

It can take three to four months for the surgery to heal completely.

What happens during prosthetic eye surgery?

For most people with an ill, injured, or malformed eye, surgery is necessary to remove the eye before a prosthetic eye is inserted.

The most common type of surgical eye removal is called enucleation. It involves the removal of the entire eyeball, including the white of the eye (sclera). In place of the eye, the surgeon will insert around, a porous implant made of coral or a synthetic material.

In another kind of surgical eye removal procedure, called evisceration, the sclera isn’t removed. Instead, it’s used to cover the porous implant inside the eye. This operation is easier to perform than an enucleation in some people, and it typically has a more rapid recovery time.

During either of these surgeries, a temporary “shell” of clear plastic will be placed behind your eyelid. This prevents the eye socket from contracting during the first few weeks following surgery.

Once healed, about 6 to 10 weeks after surgery, you can visit your ocularist to be fitted for a prosthetic eye. Your ocularist will use a foam material to take an impression of your eye socket to match or create a prosthetic eye. The plastic shell will be removed, and you’ll receive your prosthetic eye for daily wear three to four months after surgery when you’re completely healed.

How About the Prosthetic eye movement?

During surgery, your surgeon will cover your eye implant with eye tissue. To this tissue, they’ll connect your existing eye muscles to allow for natural eye movement. Your prosthetic eye should move in sync with your healthy eye. But be aware that your prosthetic eye will not move as fully as your natural eye.

What are the Possible risks and side effects of prosthetic eye surgery?

Surgery always carries risks, and surgery on the eyes is no exception. In rare instances, an uncommon kind of inflammation called sympathetic ophthalmitis can harm your healthy eye following evisceration surgery. While this inflammation is most treatable, it can lead to vision loss in your healthy eye. There is always a risk of infection at the surgery site. However, infections are uncommon and easily treated using antibiotic drops or oral antibiotics. Once you begin wearing your prosthetic eye, you may experience temporary discomfort or tightness in your eye. But over time, you’ll grow used to the prosthesis.

What happens after surgery?

You’ll likely experience pain, swelling, and nausea following your surgery, particularly in the first 72 hours. Your surgeon may administer strong pain relievers and anti-sickness medications to make you feel more comfortable. For two weeks after your surgery, your eyelids will be stitched together over your eye implant and plastic shell. In several months, you’ll be fitted for, and receive, your prosthetic eye.

How one have to care for a prosthetic eye?

Maintaining your prosthetic eye involves minimal but regular care. Here are some tips:

• Remove the acrylic part of your prosthetic eye once a month and wash it well with soap and water. Dry it before placing it back in your eye socket.
• Sleep with your prosthesis in place unless otherwise advised by your doctor.
• Place your prosthetic eye into your eye socket using a plunger designed for this purpose.
• Don’t remove the acrylic prosthesis very often.
• Use lubricating eye drops over your acrylic prosthesis.
• Rinse any debris off your acrylic prosthesis when necessary.
• Get your prosthesis polished by your ocularist annually.
• Change your prosthesis once every five years, or sooner if necessary.

What’s the outlook for having a prosthetic eye?

Prosthetic eyes are commonly used to safely replace ill, injured, or malformed eyes. Having a prosthetic can help boost your confidence following the loss of an eye. Plus, a prosthetic eye is relatively easy to wear and maintain.

If you’re thinking about getting a prosthetic eye, talk to your doctor and find an ocularist to help you understand your choices.

How one have to care for a prosthetic eye?

Maintaining your prosthetic eye involves minimal but regular care. Here are some tips:

• Remove the acrylic part of your prosthetic eye once a month and wash it well with soap and water. Dry it before placing it back in your eye socket.
• Sleep with your prosthesis in place unless otherwise advised by your doctor.
• Place your prosthetic eye into your eye socket using a plunger designed for this purpose.
• Don’t remove the acrylic prosthesis very often.
• Use lubricating eye drops over your acrylic prosthesis.
• Rinse any debris off your acrylic prosthesis when necessary.
• Get your prosthesis polished by your ocularist annually.
• Change your prosthesis once every five years, or sooner if necessary.

Maintenance of Ocular prosthesis:

Adequate care and maintenance add life to the prosthesis. Patients may experience minimal discomfort for a transient period initially until they get adjusted to it.

Dos and Don’ts in Prosthesis care:

1. Minimal handling of the prosthesis.
i. The shell can be removed once in a month and washed well with soap and water, dried and fitted by the patients themselves. Always sleep with the prosthesis in place.
ii. A plunger is provided to every patient, which helps in easy removal and fitting of the prosthesis.
iii. Frequent removal of the shell on a daily basis may lead to discharge, watering, eyelid laxity, eyelid eversion and inadequacy of the space to fit the shell.

2. Use of lubricating eye drops over the shell.
i. Provides a smooth surface for the eyelid movements over the shell
ii. Washes off the debris deposited on the shell surface.

3. Yearly polishing of the prosthesis 
i. To ensure smooth regular surface and rounded edges thus preventing undue friction between the eyelids and the prosthesis.
ii. This prevents any inflammatory reaction such as a socket granuloma formation and giant papillary reaction in the eyelids.

4. Change of prosthesis once in every five years is ideal depending on changes taking place in the socket.

5. A full-framed protective polycarbonate glass should be worn to protect the normal eye from injury as well as camouflage the minimal differences between the normal eye and the prosthetic eye.

Ocularist: A person trained in making the ocular prosthesis is called an Ocularist, Our Prosthetic clinic has three highly trained Ocularists who have a good experience and expertise in making these custom made prostheses based on individual patients’ need.

NEXT STEP

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