Previously published article on Medium.com republished here with Lauren's full permission.

Lauren Jane

Nurse turned Freelance Writer! Health and Wellness Articles. Hoping to help us all improve our Physical, Emotional, and Mental Health! Proud Momma of 3 kiddos

2023- My left eye(or the eye on the right side of this photo) is my prosthetic.

It was the home stretch before Christmas 2020. With only a few days left before the big day, I still had so much to do. My son had his last indoor soccer game of the year. Why they plan these games so close to the holiday I’ll never know. So, with shin guards in my hand, I buckled my little one in her car seat and the four of us rushed through holiday traffic to the game.

My son won his game and proudly showed off his gold trophy as we finished up some last-minute shopping. We got home, ate a late supper, and baked a batch of Christmas cookies before collapsing into our beds.

That day seemed like just another ordinary day, but I remember it so vividly. It’s permanently burnt into my brain because that was my last ordinary day. It was the last day I looked normal, even beautiful in the mirror. More importantly, it was the last day I functioned freely without a disability.

The next morning, I woke up to a picking feeling in my right eye. It felt really puffy, and I thought I must have caught Pink Eye from one of the kids. I went to the bathroom mirror and full-blown panic set in. My eye was swollen shut and the size of a baseball.

At the emergency room, the real horror began to unfold. I had somehow managed to contract a terrible infection caused by a very rare and aggressive bacteria. Saving my infected eye wasn’t even an option. It had to be removed to prevent the bacteria from spreading to my other eye leaving me blind.

I wasn’t even about to consider being a blind single mother of three kids at 37 years old. The decision was easy for me, and I don’t regret it. My options were to lose one eye, lose both eyes, or risk dying doing nothing. When those are your only options, losing one eye seems pretty good, right?

That’s my story of how I lost my eye and why I wear a prosthetic. Wearing an ocular prosthetic can be overwhelming and stressful. I wanted to tell my story so someone going through a similar situation would know what to expect and have all the information they need. So, let’s start from the beginning.

What Is an Ocular Prosthesis?

An Ocular Prosthesis is more commonly called a “glass eye” or a “fake eye”. It consists of two separate parts. The prosthesis is a shell-shaped device typically made of acrylic that fits over an orbital implant.

A prosthetic eye is used to help improve the appearance of people who have had their eyes removed because of disease or injury. It is recommended after the eye is surgically removed to support proper eyelid function.

When the entire eye is removed, an ocular implant and prosthesis prevent the tissues in the eye socket from growing together which also prevents pain.

Wearing a prosthesis drastically improves the appearance of the eye socket and is more popular than wearing an eye patch.

The Surprising Prevalence and History of Ocular Prostheses

After I had my eye removed, I felt like a complete freak of nature. I was so self-conscious and could not even look at myself in the mirror. I was terrified that my kids would be embarrassed to be seen with me.

Those six weeks felt like an eternity waiting for my incision to heal so I could get my prosthesis placed. I thought surely, I was the only person to ever go through such a traumatic event. Boy was I wrong. The most shocking fact I found is that there are more than 8 million people worldwide with prosthetic eyes. Isn’t that crazy?

The history of eye prosthetics is impressive. The earliest attempt at manufacturing a prosthetic for the eye dates back to 4800 years ago. People have been using materials such as copper, precious stones, bronze, and gold for thousands of years to improve the appearance of a lost eye.

In the sixteenth century, the first actual prosthetic eye was designed by a French doctor. He originally made it from silver and gold but later improved it to glass and porcelain.

Glass continued to be the most popular material until the 20th century when synthetic materials were invented. Most prosthetic eyes are made of acrylic now because of its durability.

Need For an Ocular Prosthesis

As we discussed previously, an ocular prosthesis is used to improve appearance or pain following the removal of an eye. Some reasons a person may need their eye removed include injury (trauma), glaucoma, infection, and eye tumors.

Eye Removal Surgery

There are two different types of surgeries to remove the eye. The type of eye condition or amount of damage to your eye dictates which type of surgery you will need.

Types of Surgeries

1. Enucleation — The entire eyeball is removed from the eye socket

2. Evisceration — The inside of the eyeball is removed leaving tissue in the outer eye and eye socket.

Eye Removal surgery is typically same-day surgery unless there are complications or a complex case. Surgery is performed under general or local anesthesia and the eyelids are usually stitched closed to promote healing.

If you have enucleation surgery, an ocular implant is needed. An ocular implant is a round device that is surgically and permanently embedded in the eye socket. It is wrapped in living tissue or synthetic cushion before placement for comfort.

Recovery takes about 6–8 weeks. Once the stitches dissolve or are removed, your physician may put a clear prosthetic in to fill out the space and promote healthy eyelid function. The inside of your eye is the same color and texture as the inside of your lip. Then you are ready to see your new best friend, the Ocularist.

Ocular Prosthesis Fitting

Once your surgical site has fully healed, it’s time to make an appointment with an Ocularist.

An ocularist is a professional who specializes in making handcrafted ocular prosthetics.

A patient usually has several appointments with the ocularist for wax fittings to custom-build a prosthetic to fit over the ocular implant. The better the fit, the better the implant moves which is very important.

Once the size and shape are right, the ocularist hand paints the iris (colored part), pupil, and blood vessels to match your healthy eye as closely as possible.

Prosthetic eyes look amazing but do have some disadvantages. The main disadvantage is that they are purely cosmetic meaning you will be blind in that eye. Another problem is that the pupil does not respond to light like your healthy eye so your pupils can appear different sizes. Lastly, the prosthetic eye moves but not as quickly or fully as your healthy eye.

Psychological Aspects of Having an Ocular Prosthesis

Losing an eye can be very traumatic. A person must adjust to a whole new self-image and appearance. Some go through a grieving process over losing the appearance they once had. They also cope with impaired depth perception and blindness on the affected side.

Prosthetic wearers also suffer from anxiety about the health of their unaffected eye. They have a chronic fear of complete blindness.

A person’s eyes are the most important feature of their face conveying self-expression and communication. Losing an eye causes a significant change in appearance. Prosthetic wearers report excess shyness, social anxiety, and depression.

Wearing an ocular prosthesis also irritates the socket causing a significant amount of mucoid discharge, eye-watering, and crusting of the eye. 90% of prosthetic wearers experience this drainage making them feel self-conscious.

It is recommended that a psychologist be a part of the care team when an eye must be surgically removed.

Future of Ocular Prosthetics

Presently ocular prosthetics look as real as they ever have but there is still much room for improvement. There are two new scientific options on the horizon.

3D Printed Ocular Prosthetic

In November 2021, the first patient was fitted with a 3D-printed ocular prosthesis. Soon most prosthetic eyes will be manufactured by 3D printers. 3D printers can produce implants more quickly and cheaply. They also look more complex and realistic.

Ocularists will not be put out of business because they will be needed for more complex cases that printing cannot accommodate at this time.

Bionic Eyes

This is the technology that anyone with any blindness watches intently. Unfortunately, bionic eye technology is still in its infancy. As technology evolves scientists continue to explore new options to cure certain types of vision loss. There is rapid progress in the development of neuroprosthetics which inspires us to hope for the future.

Commonly Asked Questions

1. How often should I replace my prosthetic eye?

Ocular prostheses typically need to be refitted or replaced every 3–5 years due to the settlement of soft tissue in the eye socket. If your prosthetic begins to appear asymmetrical or feel different, notify your ocularist.

2. How frequently do I remove/clean my prosthetic?

Use a small suction device provided by your ocularist.

Squeeze it, then push it onto your prosthetic and release it to create suction.

Once attached, pull down on the lower eyelid and gently pull the prosthetic out with suction.

Clean with any hard or gas-permeable contact lens cleaning solution.

Rub vigorously with fingertips.

Rinse thoroughly with water.

Rinse again with saline solution and reapply the eye with a suction device.

Clean every 2–3 weeks or whenever build-up occurs.

3. Can I cry normally from my affected eye?

Typically, surgery to remove your eye does not affect your eyelid or tear duct so you should be able to cry without any difficulty.

4. Should I lubricate my prosthesis?

Artificial tears and lubricant may be used but typically are not needed unless eyelid function was affected.

5. Should I wear protective eyewear?

Absolutely! It is highly recommended to wear glasses with shatterproof polycarbonate lenses even if you do not need corrective lenses. It is very important to protect your natural eye.

6. Can I shower or swim with my prosthesis?

Yes but if you are afraid of losing your prosthesis in a large body of water, wearing goggles is recommended.

7. Can I still play sports?

Yes but wear sport-specific safety glasses for protection.

8. Can I sleep with my prosthetic in?

Yes, it is recommended to always leave your prosthetic in to ensure the eye socket remains stable and healthy.

Conclusion

The loss of an eye is a shocking and traumatic event both physically and emotionally. Wearing an ocular prosthesis doesn’t fix what has happened to you but it does make living with it easier. My prosthesis has improved my self-confidence and helped me move on with my life.

Two important things that helped me were educating myself and surrounding myself with supportive people. I hope this article has answered some of your questions and made living with your prosthesis a little easier.

Sources

American Academy of Ophthalmology. http://www.Aaa.org/eyenet/article/personalized-medicine-goes-3d

Depression, Anxiety, and Stress Indicators for Prosthetic Eye Wearers. National Library of Medicine. 2021. http://www.Ncbi.nlm.nih.gov/pmc/articles/pmc320898/

Matthew Hoffman MD. Prosthetic Eye. Web MD. May 2023. http://www.Webmd.com/eye-health/prosthetic-eye-ocular-prosthesis

Moorfields Eye Hospital. Nov 25 2021. https://www.moorsfields.nhs.uk>news>moorsfields-patient-recieves-world-s-first-3d-printed-eye

The Golden Standard for the Bionic Eye. Johns Hopkins Medicine. July 2019.