How Prosthetic Eyes Are Made

Since an ocular prosthesis must be customized to match the existing eye, the process of creating one takes several days. Although artificial eyes are available off the shelf, these eyes appear unnatural and asymmetrical to the existing eye. The first step in having an artificial eye created to match the existing eye and to give the face a natural appearance is to visit on ocularist. An ocularist is a modern artisan who specializes in creating ocular prostheses. The first visit should be scheduled six to eight weeks after the eye-removal surgery, so that the socket has adequate time to heal and all swelling has gone down.

At the ocularist’s office, he or she will first take an impression of the eye socket using alginate, a substance that comes from seaweed and is similar in consistency to the white of a hard-boiled egg. This process is completely painless and the impression is made in about two minutes. The alginate is then removed from the eye socket and is encased in dental stone, a moldable material similar to plaster of Paris. Once the dental stone has formed around the impression, the alginate is removed forming a mold of the eye socket. Then, the mold is filled with molten wax, which is allowed to cool and harden, producing a wax pattern for the ocular prosthesis. The wax pattern is then fitted into the eye socket and minor changes to improve comfort and to adjust the position of the open eyelid so that it most closely matches the companion eye are made.

After the basic shape of the wax pattern is completed, the ocularist will select an iris button, which simulates the pupil, iris and cornea of a natural eye. The iris button is incorporated into the wax pattern and during a series of fittings over an approximately two hour period, adjustments are made to simulate the natural direction of gaze so that it matches the companion eye as much as possible. During this time, the ocularist will also make final changes so that the artificial eye has the appropriate prominence and contour of the eyelid.

The next step is the make a dental stone mold of the finalized wax pattern. When the dental stone sets, the wax pattern is removed and the iris button is placed into the mold in the exact same position that it was in on the wax pattern. The mold is then filled with a “dough” of white plastic, which is slowly cured in a heated water bath. The hardened plastic will eventually become the artificial eye.

Now that the basic shape is in place, the prosthesis must be prepared to be painted to match the companion eye. The first step is to file a thin layer of plastic from the front of the artificial eye. The eye is then covered with a sheet of clear polyethylene and a new layer of clear plastic. This creates a painting lens, which allows the ocularist to accurately judge how the colors will appear with all optical effects present. The ocularist then carefully paints the artificial eye to match the companion eye. In order for the match to be as close as possible, the patient must be present during this process so that the artificial eye can be compared to the companion eye. Periodically, during the painting process, the prosthesis will be placed in the socket to ensure that the artificial eye appears natural. When the ocularist has completed painting the eye, it is then coated in a layer of transparent acrylic, which will protect the painting from typical wear and tear and from polishing. The entire process, when created with the highest standards, will take one to two days. If the eye socket is atypical in some fashion the process could take longer.

Once the process is complete the most observers may not realize the owner is wearing an artificial eye. This can help to restore confidence of the prosthetic eye patient.