What is an artificial eye?

An artificial eye is properly known as an 'ocular prosthesis' (ocular - related with the eye, and prosthesis - an artificial appliance that simulates a real organ).
It is worn in the person's 'socket' (a 'pouch' behind the eyelids that has been created surgically when their real eye has been removed) and gives the cosmetic appearance of the person having two normal eyes.

What does an ocularist do?

An ocularist is a carefully trained technician skilled in the arts of fitting, shaping and painting ocular prostheses. In addition to creating it, the ocularist shows the patient how to handle and care for the prosthesis and provides long-term care through periodic examinations. They are also trained to identify problems associated with prosthetic wearers and can often direct or assist patients in this regard.

What are artificial eyes made from?

Modern artificial eyes are made from Polymethyl methacrylate (PMMA)- a hard durable plastic, not glass as many people still think of artificial eyes being made from.

Glass eyes have a comparatively short life-span of approximately 12 months. Socket secretions and tears will gradually etch the surface of the glass eye, and such imperfections are impossible to polish off leaving no alternative but to replace the eye.

Acrylic eyes are the preferable choice, providing a much better fit. They can be cut, polished and adjusted for comfort, the colour is easier matched to the existing eye, and they do not shatter like glass ones can - and are easy to care for.

Rumours persist that there are artificial eyes made from coral. This is not true, but there do exist Orbital Implants that are made from coral - and others that have the same features as coral - but nowadays 99% all artificial eyes are plastic.

What is the difference between stock and custom made eyes?

Ready made or stock artificial eyes are mass-produced. A custom made artificial eye on the other hand, is made by your ocularist to fit you and you alone, matching any detail.

Except as a temporary prosthesis, or in the case of an indigent patient where no custom designed prosthesis can be afforded, there are no pre-fabricated or 'stock' eye prosthesis fabricated or provided to any individual or dispensor.

Stock eyes are chiefly supplied by the state hospitals at a subsidised rate.

How often should I visit an ocularist?

The artificial eye, like a hard contact lens, needs to be polished regularly in order to restore lustre finish and ensure that the surrounding tissues (e.g. Giant Papillary Conjunctivitis - a nasty condition derives under the lids if the prosthesis has not maintained a smooth anterior\front surface. This condition causes pussy discharge and the lens or prosthesis will have to remain out of the socket for a lengthy period of time for it to recover. A loose-fitting prosthesis can also cause irritation and a weepy socket. Speak to your ocularist about this.) are sound and quiet and that the artificial eye result is as good as possible. Infants and young children are seen every 3-6 months (It is important to maintain a snug fit in the socket for the benefit of optimum growth of the bony orbit as well as maintaining satisfactory lid apertures) and all other patients at least once every 6-12 months.

How much does an artifical eye cost?

In South Africa it varies greatly and you are encouraged to discuss this personally with your ocularist. It is difficult for an ocularist to quote for the work without having examined the patient.

Do Medical Aid programs/insurance cover this?

If medical aid cover is available, it is in the interests of the patient to ascertain authorization for it, however, your ocularist will gladly assist in providing the necessary measures to obtain full benefits from your policy. However, it is of utmost importance that the patient recognizes the fact the he or she is liable for the costs in full.

Is there a South African Society of Ocularists?

Yes there are two, AOOPA (African Ocular and Orbital Prosthetic Association) and OASA (Ocularist Association of South Africa).

What training should an ocularist have?

A skilled ocularist should have at least 5 years apprenticeship under the supervision senior ocularist. Training does not stop here though. As technology improves, so your ocularist should endeavour to keep abreast of all the latest info, manufacturing and fitting tips etc.

What is an ocular orbital implant?

This is an item derived from coral, bone, glass, perspex or various other materials to fill the volume of the orbit created by the removal of the eye or the contents of the eye. There are many excellent implants on the market and this would be discussed with your ophthalmologist and ocularist

I have lost my eye! What now?

Where do I go?
Your ophthalmologist or optometrist should be able to assist in referring you to a reputable ocularist. Arrange a consultation with an ocularist - allow approximately 12 to 112 hours.

Other Ocularist Associations:

The most well known is the American Society of Ocularists – ASO and the AEO which is the Association of European Ocularists. There are Associations in Australia, South America and India.

The ocularist will brief you about:

  • What results to expect, show you case studies, e.g. will my eye move etc. photographs and relate experiences.
  • The fitting procedures will be discussed in full to alleviate any potential anxiety. This is NOT a painful procedure.
  • Schedule bookings - expect between 3-6 appointments of approximately 1-2 hours each, depending on the complexity.
  • Generally familiarize the patient with the manufacturing process and concepts - answer all questions.
  • Discuss medical aid coverage or alternative payment schedules.
  • Patients briefed as to lifespan of prosthesis. (approx 5 years) Anxiety is totally normal. That is why a patient is encouraged to go and see the ocularist who deals with the traumas and fears of people in this predicament. Often the patient sees the ocularist before he or she has undergone the initial operation of removing the eye. This can be most encouraging for the patient and family members and this service is totally free of charge.

We have a fantastic 'support' group made up of people who have experienced first hand what you are now going through. For patients who have a child or baby in this situation it is especially encouraging. Please contact ocularist to gain access to the qualified members for this opportunity. It is not even necessary to meet with someone. Often a telephone call will do.

Is there anything I should watch out for, or any situations that I should take care in now that I have only 1 eye?

There's no easy answer, generally the socket must stay well lubricated as dryness can result in a host of complications, one being a condition called Giant papillary conjunctivitis. This is most debilitating for artificial eye wearers as it results in a thick, sticky discharge and can only be treated properly on removal of the artificial eye for a lengthy period of time. Another prevention is to see your Ocularist regularly (as often as every 3-6 months if you should suffer from a dry socket) or some have found it worth while removing the artificial eye in the evening although this is not generally the case and should be discussed with your Ocularist.

It is not uncommon to experience dryness in smoky atmospheres as well as air-conditioned rooms or rooms with central heating. In Cape Town for instance, summer could promote more of a problem with the dry, hot, windy conditions and the high pollen count in early summer (Hay fever can also cause irritation to the socket). It is always a good idea to use a good lubrication and have it handy. Contact your nearest ocularist for more info about lubricants. Please remember the front and back surface of the prosthesis must always be smooth and shiny. We have found that the most common cause for losing an artificial eye is in the sea - be careful when body surfing, surfing or skiing! Good idea to insure them.

It's not unusual for a patient to suffer from latent shock from the loss of the eye, even years later. Good idea to speak to a counselor or psychologist about it.

Although many artificial eye wearers choose not to wear glasses, it could be a consideration as they are an added protection and can even add to the final cosmetic appearance. We can advise patients on accessories or ways to improve the overall cosmesis.

Finally, have your sighted eye checked regularly (at least once a year) by your eye care practitioner or ophthalmologist.

What does polishing of a prosthesis entail?

This is the process whereby the ocularist uses special polishing compounds designed for the specific plastic and heavy duty lathes. It brings the anterior and posterior aspect of the prosthesis back to its original lustre.

This process should be done every 6-12 months. Some people who cannot handle their own prosthesis come to us every 2-3 months.

It takes approximately 15-30 minutes. The occularist will also check the socket and surrounding tissue.

What is a scleral lens/shell?

Is a lens designed and manufactured to fit over a damaged or unsightly blind eye. It is also fitted over a micro-ophthalmic or pthisical eye.

Can my old/existing prosthesis be worked on or changed?

This depends entirely on the age of the prosthesis and the type of plastic and curing used at the time of manufacture. Your ocularist will be able to assist in establishing this answer.

What is an orbital conformer?

This is a spacer fitted over the conjunctiva (covering tissue) of the orbital implant to avoid closure of the fornices.

What is a Fornix?

It is the space between the lids and the globe of the eye or the remainder of the eye or orbital implant.

How to go about treatment of young children?

Children respond to their parents reaction most of the time. As difficult as it is, parents must be reassuring and positive! Even if the initial result is not satisfactory, it is very important to show a positive reaction - remember, working with children is a challenge in that it takes longer to obtain the best result and we first fit temporary shapes to get the child to accept the procedure. Please work along with the ocularist and contact us before you come in for your first appointment.