A Customized ocular prosthesis (prosthetic eye) is considered when we have to remove an eye due to
- Eye Cancer (for example Retinoblastoma in children)
- Irreparable eye injury due to trauma (children & adults)
- Cosmetically disfigured eyeball with no hope of visual rehabilitation
There are two professionals required for the success of this surgery
- Doctor- An ophthalmologist with specialized training in Ophthalmic Plastic Surgery also known as Oculoplasty. The doctor is responsible for the surgery part of the procedure.
- Ocularist – A person who designs the customized artificial eye prosthesis after the surgery is over.
Before that we have to understand the concept behind the surgery and I will be keeping technical details out of this answer.
Take a look at this Image.
In the above picture you can see the orbital implant in place of actual eyeball and an artificial eye is placed on top of the orbital implant.
So to have a good cosmetic outcome there are 2 stages:
1. Stage I – Surgery
- Done by an Oculoplastic surgeon
- Eviceration/Enucleation with Orbital implant
- This is the most important part of the procedure since 70% of volume is contributed by the orbital implant.
- Techniques of how this is achieved may vary between surgeon to surgeon.
- In this surgery the eyeball is removed (Enucleation) or it’s contents removed (Eviceration) and replaced with an orbital implant. This is a video of the surgery (Enucleation with implant)
Disclaimer: Please do not watch it if the graphic nature of the surgery makes you queasy.
2. Stage II- Customized ocular prosthesis
- Done by an Ocularist who is someone who specializes in fabrication and fitting of an artificial eye
- This process is undertaken 6 weeks after surgery once the socket has healed and quiet. At this stage there is a covering over the orbital implant making it a smooth lines socket.
- The Ocularist takes a mould of the empty socket and fabricates the Ocular prosthesis which is often made of light weight ceramic material. (no two sockets are the same so this contributes to the customization.
- The details of the eye are painted manually by looking at the other eye and using photographs to compare before being finalized for wear.
- The fitting is done by the Ocularist which is later confirmed by the surgeon
One also has to understand that having a prosthetic eye is for cosmesis and not for vision. This needs to be stressed and the patient needs to be counselled regarding the pros and cons of surgery including discussing in detail some of the complications that can happen and the maintenance required after the procedure is completed.
For see more outcomes check out the following links.