Frequently Asked Questions

General Questions about Artificial Eyes

 

Q: What is an Artificial Eye?
A: It is a prosthetic unit that serves to replace the lost orbital volume when the living eye is either shrunken or surgically removed.  It’s anterior (front) surface simulates the companion eye.


Q: What can an artificial eye do for me?
A: It can eliminate physical stress caused by facial imbalance of the eyelids.  Artistically, a good matching ocular prosthesis can lessen the psychological hurt of an eye loss.


Q: Will I be able to see with this prosthesis?
A: This is not an unusual question.  Of course the answer is NO, but we have had patients tell us they can see better when the prosthesis is in the cavity.  Our only explanation for this phenomenon is that you have relieved any undue tension on both upper lids when they are symmetrically aligned.


Q: What is an Implant?
A: It can be any inert (avascular or porous) material, or autogenous (bone or dermis fat graft) tissue.  All the implants are designed to replace orbital volume loss.  Most of them are also designed to offer a range of motility by attaching the eye muscles to them.


Q: What kind of implant is best for me?
A: It can be contingent upon the diagnosis for removal of the eye, the condition the extraocular muscles, the eyelids and the available orbital tissues.


Q: What are Stock Plastic Eyes?
A: Stock plastic eyes are mass produced ocular prostheses.  Initially, they were duplications of the most common empirically fitted left and right glass eye sizes, shapes and colors.  Presently, if available they are used as temporary post-operative prostheses, when an acrylic or silicone conformer is unsuitable or for the indigent.


Q: What are Custom Plastic Eyes?
A: Custom plastic eyes can be classified as being made for the individual who requires this service.  The custom prosthesis can be empirically fitted from a preformed shape and modified with wax and/or acrylic prior to its fabrication, or it can be impression moulded for a more exacting fit, and then modified to accommodate any weakness in orbital tissues and/or the eyelids.  This service would also include colour matching of the iris, sclera and vascular pattern of the fellow eye.


Q: What is the Difference Between "Stock" and "Custom" Artificial Eyes?
A: "Stock" eyes have assorted standard iris colors and whites of the eye.  They are mass produced prosthetic units and do not fit anyone in particular.  The "Custom" prostheses are made to adapt to the contour of the orbital tissues and eyelids, and colored to match the companion eye. They make for more a symmetrically balanced result.


Q: How long does an artificial eye last?
A: In general, plastic artificial eyes, unlike glass eyes, last for a long time when properly made and cared for.  Most ocularists report a replacement is required every 5 to 8 years, because of bony orbit development early in life, and/or tissue changes in adult life.  However, we have patients wearing the same prosthesis for over 30 years.


Q: How do I obtain an artificial eye?
A:You may refer to the Ocularists Association of Southern Africa (OASA) via info@oasa.org.za or on 081 392 8976 to get information on the closest Ocularist to your residence.


Q: What is the process to procure a custom fitted artificial eye?
A: Patients are referred to the ocularist by their eye specialist or optometrist or even through a friend. Appointments would then be arranged for the following procedures (initial evaluation, impression moulding, prosthetic model fitting, colour matching of the iris, sclera and vascular pattern simulation, and fitting of the completed prosthesis). 


Q: Is it necessary to return to the ocularist on a regular basis?
A: Yes, you should have routine follow-up visits to determine if your prosthesis needs to be polished, or if an adjustment or replacement is required.


Q: How do I care for my prosthesis?
A: The Ocularist will instruct individually upon consultation but there are various products available for both cleaning and insertion of the ocular prosthesis.


Q: Why should I use a tissue to wipe the artificial eye instead of a handkerchief?
A: Tissues from a container or 'pocket pack' are reasonably germ free, whereas, even a clean handkerchief in the pocket or purse can become contaminated.


Q: Is there a certain way I should wipe the prosthesis to prevent it from falling out?
A: In the sighted eye you always wipe away from the nose.  This prevents any foreign particles (eyelashes, dirt specks) from becoming embedded in the tear duct.  However, when wearing a prosthesis you would always pat or wipe toward the nose to prevent the lower eyelid from collapsing and ejecting the prosthesis.


Q: Will I have to remove the prosthesis?
A: Your meibomian and lacrimal glands, and the mucus membrane release fluid.  This combination of liquid causes a protein deposit to gradually accumulate on the prosthetic surface.  This build up can irritate the underlying tissue.  A daily hygiene routine of cleansing the lids, lashes and surface of the prosthesis (without removal) will forestall the time when it becomes necessary to remove it.


Q: How often do I have to remove my prosthesis?
A: This is dependent upon your ability to completely close the eyelids, if you have any allergies, and your personal hygiene care of the prosthesis.  Some patients have to remove it daily, others once a week, a month or annually.  We will evaluate your tolerance level after the prosthesis is worn for a time period.


Q: How do I remove and reinsert the prosthesis?
A: Removal and insertion of the prosthesis is relatively simple. During your appointment, we will instruct you how to remove and reinsert the prosthesis. 


Q: How do I tell the top of the prosthetic eye from the bottom?
A: The prosthetic eye will not be coloured on the top section and will appear white.


Q: My vision is very poor in the remaining eye, how will I be able to identify top from bottom if I cannot see the marking?
A: This is when you will rely on touch.  Each impression moulded ocular prosthesis has a unique peripheral contour.  In most shapes there will be a noticeable trochlea notch.  It is an indentation located on the prosthesis that sets near the upper inner area of the socket.  If this is still difficult to identify we will create a nick(s) at the top of the prosthesis.  (A technique used for the blind patient.).


Q: My fingers are not as nimble as they use to be.  I don't know if I can remove the artificial eye, and the hands are not that steady to catch the eye if I try to use my fingers for removal.  What else can I do?
A: For patients with arthritis, rheumatism or just stiffening of the finger joints, we can provide you with a solid silicone prosthesis remover, which is similar to a suction cup and only requires you to hold it and make flush contact with the prosthesis (squeezing is not required).


Q: What about the use of eyeglasses?
A: It is important to wear polycarbonate spectacles for protection of the remaining eye (especially for children).  Spectacles can also be prescribed for corrective cosmetic optics for modification of any asymmetrical alignment of the prosthesis and/or eyelids that cannot be corrected surgically or by the ocularist.  This would include ("+" or "–") lenses and/or cylindrical power lenses.


Q: Should I experience any occasional discomfort wearing the prosthesis?
A: When an ocular prosthesis is properly fitted, there should be no discomfort.  However, on very cold or windy days you may experience dryness on the surface of the prosthesis.  This dryness causes the upper eyelid to stick to the prosthesis, especially, if you do blink too often.  This may be remedied with a wetting solution.


Q: What inconvenience should I expect?
A: Any inconvenience would relate more to the loss of sight in one eye, rather than the wearing of a prosthesis.  Therefore, the problem is loss of depth perception and a percentage of your peripheral vision.  We would refer you to the Frank B. Brady’s book entitled "A Singular View."


Q: Can one participate in sports activities even when wearing an artificial eye?
A: Yes, participation in contact sports is possible providing you wear protective polycarbonate glasses to protect both your eye and the prosthesis.  You will have two problems to contend with however, depth perception and peripheral vision.  We have found that the younger one is when the eye loss occurs, the easier it is to adapt and compensate for these two important factors.


Q: Will the allergy season and summer heat be of any concern?
A: Yes, the hot summer heat together with any allergies (sinus, hay fever, asthma), you will experience more than the normal amount of tearing or secretions.  Always carry a pocket pack of tissues to keep the surface clean.


Q: Will very cold temperatures have any affect on wearing the prosthesis?
A: Yes, in the winter, the prosthesis can feel like an ice cube if you are an indoors person most of the time.  Skiers will usually wear goggles with an eye pad under the one lens, although construction workers are accustomed to cold weather and have little complaint. However, the milder African winters make this less of a problem locally.


Q: The eyelid becomes irritated and sore because I cannot close the eyelid completely.  Is there something to make the eyelid more comfortable?
A: There are several heavier viscosity liquids that will keep the prosthetic surface moist for a longer period of time than wetting solutions.


Q: Why does secretion accumulate on the lower eyelid and lashes?
A: The anatomy has changed when there is loss of an eye.  Therefore, the tear duct in the inner canthus of the lids is not able to act as the drainage for all of the tears.


Q: Are Artificial eyes covered by my Medical Aid?
A: Most Medical Aids cover the prosthetic eye under the non-surgical external appliance section of the fund. The Ocularist you chose to make your eye will assist with the quotations and necessary paperwork required.


Q: Can Artificial eyes be insured?
A: Most insurance plans cover replacement of artificial eyes. The Ocularist you chose to make your eye will assist with a quotation and your insurance broker will advise you on how to get your prosthesis covered, normally under the all-risk section of your household policy.

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