There is a surprising number of people who have lost one of their eyes.  We’ve heard about the famous ones, Sammy Davis, Jr., Peter Falk and Lauren Scruggs just to name a few.  The art of making an eye has changed a lot over the decades.  At one time you went to an ocularist who had drawers full of eyes of different shapes and colors.  The ocularist would hold each eye up to your face until she/he found one that looked like the other.  After finding one that looked good for you, she/he would add a product to the back make it fit in the socket.  The process was short and the results were tolerable.  The eye didn’t fit perfect, but it was good enough.

Now the process has become much more personalized and it takes a little more time.  First the ocularist will take an impression of your eye socket.  They use the same material to get an impression of your teeth.  From that the ocularist can make a mold that will make an eye that will fit perfectly.  The fit is the key to comfort.  After the back is  set the art begins.  The ocularist will paint an eye on the prothesis.  There isn’t anyway to make it perfect, he uses a number of techniques to get the pupil and iris to appear to change with light changes.  Once this is complete, the ocularist sandwiches the different layers of the prosthesis.  Then, your eye is ready to wear.  The prosthetic eye is only similar to having contacts in that feels about the same.  

Keys to Success

Don’t Touch It

The more the prosthesis is moved or removed, the more irritated it becomes.  You should not remove the prosthesis unless you are having it cleaned.  When you do need to rub your eye, ensure you blink first and rub from the outside inward.  If you don’t it could get awkward.  If you rub too hard, the prosthetic eye can pop out.  There’s just no easy recovery to a discussion when this happens.

Lubricate Often

You should keep lubricant drops with you every where you go.  You will do well if you have several bottles in all the right places.  The environment you live in and your level of fatigue will have a big impact on how dry the eye becomes.  If your eye does get dry, it will become uncomfortable and the socket will get irritated.  Eye drops like Visine will not do a good job.  You need serious lubrication.  Systane Long Lasting Lubricant Eye Drops works well for me.  You also need a night time lubricant.  Again, Systane Nighttime Lubricant Eye Ointment works well.  If you ever need to remove your eye for more than a few minutes, it is important to store it in saline solution.  This will prevent the different layers from drying out and separating.

Clean Regularly

You should plan to have your prosthesis professionally cleaned once a year.  Any more than that and it can damage your prosthesis.  You should also plan to clean it once a month.  DO NOT use hand soap.  Use hard contact cleaner.  Optimum ESC by Lobob works well.  Put about a teaspoon in your palm and gently rub it for a minute.  Then rinse it thoroughly.  Ensure you don’t use hot or cold water.  Either one will not feel good when you put the eye back into the socket.

Plan for the Environment

Ice cream headaches are nothing compared to a frozen prosthesis.  It doesn’t take much to make it painfully cold.  The quickest defense is a quick wink.  Before you go out into the cold ensure your eye is closed.  If that doesn’t keep the cold out, just put your hand over the eye.  That will be enough to get you from the car to the door.  If you are going to be out in the cold for longer than a minute, holding you hand over your eye is impractical.  Ski googles work well to protect you eye.  They keep the wind and cold from freezing the plastic.

Wind is no longer your friend.  A constant breeze can dry out your eye faster than you can lubricate it.  You need to find a method to deal with it.  Sunglasses and a scarf are probably your best defense.

When you go swimming you need to wear googles.  If you don’t driving into the water could result in your eye popping out.  There will be fewer embarrassing events than have a diving contest to find your eye at the bottom of the pool.  Another problem will be roller coasters.  Be sure to keep your hand over your eye during your ride.  The g-forces  will pull on your eye and it can easy fall out.  Unless your blessed, it’s unlikely you’ll ever recover it.

Since your down to one eye, you need to protect the one you have left.  A good pair of glasses is your best defense.  Even if you don’t need a corrective lens, you should wear glasses with polycarbonate lenses.  Polycarbonate lenses are impact resistant so they won’t break and shatter.

Long Term Problems

You will most likely wear a prosthetic eye for decades.  The longer you wear it, the more likely you will suffer effects from it.  The lower lid, side wall or floor of the socket will eventually breakdown and need to be repaired surgically.  The lower lid stretches out of shape so you will have trouble keeping the prosthesis in place.  Although less likely, the implant in the socket can become ineffective and need to be replaced.  It is important not to be too quick to begin repairing the socket.  Fixing one problem can create a new problem.  Eventually you will get to a point where the problems can not be repaired.

Infection will be a constant battle.  Since you can’t clean your prosthesis often, the likelihood of it getting infected is increased.  Bacterial infections and Giant Papillary Conjunctivitis (GPC) will be a constant.  It is important to follow the doctor’s advice in dealing with these issues.  Most likely you will simply need to instill one or two drops a day.  To prevent these infections from getting out of control, it is a good idea to use a hot damp compress daily.

Since your head doesn’t grow as fast as your body, you can expect to need to replace it every five years, if you lose your eye when you are young.  If you are an adult, the prosthesis will last a lot longer.  A prosthetic eye can last between 10-15 years.  The cost can range from $2500 - $5000.  Insurance coverage on prosthetic eyes is usually limited to the initial eye after surgery.  Insurance usually doesn’t cover any replacement of a worn out or ill-fitting eye.  Living with a prosthetic eye can be as easy as living with contacts.  Eventually, you’ll look in the mirror and forget which one is which.