FAQ

Please read all the answers to possible questions you may have as a patient.

  1.  What is an ocularist?
  2.  How long have artificial eyes been around?
  3.  What's the difference between "stock" and "custom" eyes?
  4.  How often do you have to see an ocularist?
  5.  What is the American Society of Ocularists?
  6.  How do I find a good ocularist?
  7.  Who certifies ocularists?
  8. Are there different qualities in custom ocular prostheses?
  9. What kind of results can I expect?
  10. How do I remove the eye?
  11. How is an artificial eye made?
  12. When should I use an eye patch?
  13. Will people notice that I have an artificial eye?
  14. What training does an Ocularist have?
  15. What material is used in making the prosthetic?
  16. Is an artificial eye considered cosmetic by my insurance?
  17. What is the youngest a child can be fitted?
  18. What is a scleral shell?
  19. What do I do if I have irritation, swelling, or pain?


What is an ocularist?


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.

How long have artificial eyes been around?


Artificial eye-making has been practiced since ancient times. The first ocular prostheses were made by Roman and Egyptian priests as early as the fifth century B.C. In those days, artificial eyes were made of painted clay attached to cloth and worn outside the socket.

It took many centuries for the first in-socket artificial eyes to be developed. At first, these were made of gold with colored enamel. Then, in the later part of the sixteenth century, the Venetians started making artificial eyes out of glass. These early glass eyes were crude, uncomfortable to wear, and very fragile. Even so, the Venetians continued making them and kept their methods secret until the end of the eighteenth century. After that, the center for artificial eye-making shifted to Paris for a time; but by the mid-nineteenth century, German glass-blowers had developed superior techniques, and the center for glass eye-making moved to Germany.

Shortly thereafter, glass eye-making was introduced in the United States. During World War II, the imported German glass used for glass prostheses became unavailable in this country. As a result of this shortage, the U.S. Government, in conjunction with a number of American firms, popularized the techniques for making artificial eyes out of acrylic plastic.

The popularity of this method has continued to increase over the years, and today the vast majority of patients wear ocular prostheses made of acrylic.


What's the difference between "stock" and "custom" eyes?


"Stock" or "ready-made" ocular prostheses are mass-produced. Since a "stock eye" is not made for any particular person, it doesn’t fit any particular patient. A "custom" ocular prosthesis, on the other hand, is made by your ocularist to fit you and you alone.

How often do you have to see an ocularist?


The ocular prosthesis, like hard contact lenses, needs to be polished regularly in order to restore the acrylic finish and insure the health of the surrounding tissues. It is generally recommended that infants under 3 years of age be seen every 3 months; patients under 9 twice yearly, and all other patients at least once a year.


How do I find a good ocularist?


In most states, there are no laws governing ocularists. When choosing an artificial eyemaker, you should consult your state regulations and look for the following credentials:
Membership in the American Society of Ocularists
Certification by the National Examining Board of Ocularists


Are there different qualities in custom ocular prostheses?

Yes there are. It is all related to  the specific expertise, knowledge , continuous certified education , Lab process technique and personal talent.

 

You and your prosthesis:

After you receive your new artificial eye (ocular prosthesis), there are a few things you should know about caring for and handling it properly:

1. Never clean or soak your artificial eye in rubbing alcohol because it will crack the PMMA Medical grade and destroy the ocular prosthesis.

2. Remove the ocular prosthesis only as necessary and according to your  qualified ocularists recommendation. Too much handling can cause socket irritation and result in excessive secretions.  Before wiping your artificial eye always close it first and wipe only from your ear toward your nose.  Otherwise it is possible to depress the lower lid below edge and the prosthesis and it will either turn in direction or come out.  If it does not come our it is very possible that it will turn in the socket, usually pointing in an outward direction requiring you to realign it.

3. If you remove your ocular prosthesis, be sure to store it in contact lens saline solution. This will keep deposits from drying on the surface.

4. Your ocular prosthesis in some cases it may have a colored spot or mark on it and in most cases the spot goes up, under the upper lid upon insertion. It has been placed there to help you with the correct alignment... If you're in doubt, ask your ocularist.

5. To clean your prosthesis. Wash the eye between your fingertips. A damp Kleenex or cotton ball is also helpful to wipe away softened deposits from the surface.

6. If you wish to or need to rinse out the socket, use sterile saline with an eye cup. Usually the eye cup can be used with the prosthesis left in place. Sterile saline is available at the drugstore and is found in the contact lens solution section of the store. 

The routine removal of the prosthesis at night is no longer doctor recommended unless there are special problems such as excessive discharge or discomfort. The accepted current advice is that if it isn't bothering you, leave it alone.

If and when you do remove your prosthesis, make certain it is kept in water so that any secretions that may have built up on the surface will not dry and become an irritant.   If you have a spare or duplicate eye, it should be kept in a watertight container filled with a preserved saline contact lens solution to avoid drying out and possible delaminating. However, if the eye is new and has not been worn it may be stored dry.

Storage in strong solutions should be avoided to prevent absorption of these fluids by the PMMA Medical grade.

The frequency of cleaning your prosthesis is an area in which many ocularists and ophthalmologists do not agree. Some recommend their patients remove the prosthesis at regular intervals, perhaps on a daily basis, for cleaning.

Others feel that handling the prosthesis only when necessary will minimize infection in the socket, resulting in less discharge and build up of eye secretions.

You will undoubtedly determine from your own experience the best interval for cleaning your prosthesis. Some patients find a weekly, monthly or bi-monthly cleaning necessary or more comfortable.

We believe a good average for our  custom products is a monthly cleaning and inspection for patients who have undergone an evisceration or Enucleation.

Custom Sclera shell requires often removal cleaning and inspection, and according to your doctor's opinion.

Before removing your prosthesis first wash and rinse your hands thoroughly. Hold the palm of one hand below the eye your removing to catch it.  Depress the lower lid and pull down and outward away from your nose with the index finger of the other hand so that the bottom edge of the prosthesis slides out of the socket and into your hand. You may also want to consider using a suction cap to remove the eye. To do this, wash and rinse your hands thoroughly and moisten the tip of a prosthetic suction cup in water.

 

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.


What kind of results can I expect?
Results vary from person to person and are dependent on factors such as age, type of surgery and implant, and general condition of the eye socket.  See examples of actual patient results in our web site  for a general idea of optimal results. However please discuss your anticipated results with the ocularist at your visit.

 

How do I care for my prosthesis?
Artificial eyes are made out of material that will craze (crack) if it comes in contact with alcohol or any chemical product containing alcohol.  The proper way of cleaning the eye is simply washing with warm water and buffing with a soft cloth.  Some users prefer to soak the eye in saline cleaning solution (similar to that used for contact solution) although if you experience significant protein buildup, you should see your Ocularist for cleaning and polishing.

How do I remove the eye?
Most patients simply pull the eyelid upwards and look down, then gently push the eye out of the socket.  There are suction cups available that can be used as well.  If using a suction cup make sure to tilt the top of the prosthesis and slide it downwards.

How is an artificial eye made?

Please follow this link to see how a prosthetic eye is fit and manufactured.

How can I achieve movement of the prosthesis?
Movement is dependent on the implant used by your ophthalmologist and on the type of surgery performed.  Some movement is usually possible depending on the condition of the socket.  Read more about hydroxyapatite implants or discuss this with your ocularist.

When should I use an eye patch?
You should use an eye patch as directed by your ophthalmologist or if you wish to conceal your socket until your prosthesis is fitted. 

Will people notice that I have an artificial eye?
Patient results vary from case to case, however many people have artificial eyes and successfully conceal this from the public (and in some cases, even from close family and friends!)  Please share any concerns you have regarding the results of your prosthesis with your ocularist.

What training does an Ocularist have?
To become a Board Approved Diplomate Ocularist (BADO), one must complete a 5 year apprenticeship with another Ocularist and comply with all the regulations and continuing education standards set by the American Society of Ocularists (ASO).  In addition, ocularists are certified by the National Examining Board of Ocularists (NEBO).   The Board Certified Ocularist (BCO) represents the highest certification of an ocularist and indicates a high degree of experience and dedication.

What material is used in making the prosthetic?
Eye prosthetics are made using dimensionally stable, medical quality PMMA Acrylic.  This is the same material used in some hip replacements and related procedures and it has been found to be very bio-compatible after being surgically inserted into the body; therefore allergies to the material are highly unlikely.

Is an artificial eye considered cosmetic by my insurance?
There are very few insurance policies that consider artificial eyes purely cosmetic since they do function as a protective device to the eye socket.  Some policies only cover a portion of the prosthesis, while others cover it at 100%.   Please contact your insurance company to obtain benefit information, or contact your Ocularist and we can obtain benefit information for you. 

What is the youngest a child can be fitted?
Patients as young as 6 months of age have been fitted with prosthesis.  It is important that infants and children be evaluated by the ophthalmologist and referred to have an artificial eye made.  If children are not fit with an eye and do require them, facial asymmetry can result as the child grows and develops.

What is a scleral shell?
A scleral shell is similar to an artificial eye with the difference being the depth of the posterior (back part).  A shell covers the eye that has not had a full enucleation (removal of the eye) and can be used with phthisical eye patients or those that have had injuries.  Your ophthalmologist will refer you to have the proper item fit.

In case of emergency or loss of the prosthetic, what information should family and friends know?
Anyone who may come in contact with the prosthesis should know not to place it in rubbing alcohol or related products.  

What do I do if I have irritation, swelling, or pain?
If you are experiencing pain that is related to the prosthesis, please contact your Ocularist immediately.  If you are experiencing general irritation, discharge, and discomfort with your eye socket please contact your ophthalmologist immediately.

 


© Sankey International 2016