There are several different types of artificial eye which can be worn in the eye socket for different purposes. Here you will find an explanation of what each one is and why it is used.
Types of ocular prosthesis
Conformer
Clear silicone or acrylic conformers retain socket shape post surgery whilst healing process is underway. They should stay in place until approximately 6 weeks after surgery.
Artificial Eye
Worn inside the eye socket in the absence of an eye(s) due to enucleation/evisceration to treat cancer, traumatic eye injury, blind painful eye or anophthalmos (born without an eye). Made from PPMA (Poly Methyl Methacrylate) – Acrylic. A unique artificial eye is produced from a mould taken of the individuals socket. A moulded eye ensures the best possible fit and maximises any movement from underlying muscles upon directional gaze. Painted by hand to best match the fellow eye.
Cosmetic Shell
Worn over a blind, shrunken and cosmetically poor eye. Essentially a cosmetic shell is the same as an artificial eye but usually much thinner to accommodate the underlying eye. To enable wearing of a cosmetic shell the eye must be somewhat shrunken (phthisical) to allow for space to insert the shell without the eye looking too large. It also allows the Ocularist to paint on the surface. Fitting a cosmetic shell can be trickier than an artificial eye due to the irregular nature of the underlying eyes surface and sometimes because of eye sensitivity. A trial period is necessary with a cosmetic shell to assess whether it is a viable option or not. A cosmetic shell is not intended to be worn permanently.
Socket Expander
Socket expansion is often necessary for children with anophthalmia or microphthalmia (no eye/eyes or very small eye/eyes). An ophthalmology Consultant will refer a child to our service if they have been born with one of these conditions. A course of intensive treatment will take place to try and expand the dimensions of the socket as the child grows. A series of clear conformers, increasing in size will worn. The aim of this is to promote growth within the socket and to support bone growth as the child develops. After reaching an optimal size, a painted artificial eye will be an option.
Insertion and removal of an artificial eye
Always handle an artificial eye with clean hands!!
The eyelids hold an artificial eye inside the socket. To remove the artificial eye gently pull down the lower lid until the edge of the prosthesis is visible. Using a fingertip, ease the bottom of the artificial eye out. Looking upwards can also make it a bit easier to come out. Plastic extractors and rubber suction cups can also be provided by the clinic for anyone who struggles to get their prosthesis out using this method.
To reinsert an artificial eye is the reversal of the previous method. Start by holding the artificial eye with the most pointed area towards the nose, lift the upper eyelid and slide the prosthesis directly up and into the socket. Then pull down the lower lid, and secure the eye inside the lower lid. Useful tip – the artificial eye will slide in easier when wet, so running under water or using artificial tears can help.
Care of an artificial eye
How often someone removes their artificial eye for cleaning is mostly down to personal preference, although it is something we encourage.
An artificial eye requires minimal maintenance as long as there is no discomfort or excessive discharge. It should always be in the socket including when sleeping. We strongly discourage leaving the artificial eye out for long periods. Although rare, sockets will sometimes contract (shrink) if the eye is not in for a period of time. Removing the eye for only a short time when cleaning, can hopefully avoid this from ever happening.
Note for cosmetic shell wearers – Typical wear time for a shell is 8-12 hours and the wearer should always remove it before sleeping. The underlying eye needs a rest and if worn constantly could lead to the eye becoming red and very painful possibly sustaining further damage.
Some stickiness upon waking in the morning is normal. Most wearers report this to be the case and they can clean it away without actually having to remove the eye.
Should the artificial eye become irritable removing and washing can often resolve the issue. Sometimes a build-up of dirt on the surface can result in a gritty feeling when blinking. A foreign body such as a trapped eyelash can also cause irritation.
When washing, use warm water and whichever hand soap you like, many prefer a fragrance free soap. Rub the artificial eye between the fingers and thumb to remove any surface deposit and rinse the eye well before re inserting. Tip – always make sure the plug is in the sink when cleaning an artificial eye as if it drops down it is gone!
No specialist cleaners required. It is not advisable to use boiling water, abrasives, chemicals or detergents as these can permanently damage an artificial eye.