Prosthetic Eye (Glass Eye or Ocular Prosthesis)

What is a prosthetic eye?

A prosthetic eye, or ocular prosthesis, is a medical device you wear in your eye socket that looks like a natural eye. It fills the space that once held an eye lost because of an injury or medical condition.

You may also use one if you were born without an eye, due to a congenital (present at birth) condition like microphthalmia or anophthalmia. While most artificial eyes don’t use glass anymore, people sometimes still call them glass eyes.

Prosthetic eyes serve two main purposes:

• Aesthetic. Appearance is important. A prosthetic that looks like a natural eye can be the difference between feeling confident and comfortable instead of anxious or embarrassed.
• Medical. They take the place of eye tissue that’s no longer there. They also keep foreign materials and objects out of your eye socket.

Types of artificial eyes

An ocular prosthesis is the main type of artificial eye. Prefabricated or “stock” ocular prostheses are available. But most experts strongly recommend using a customized prosthetic. Other types of artificial eyes include:

• Prosthetic contact lens. A prosthetic contact lens can enhance your appearance if you have a damaged or disfigured cornea. You can also use these lenses for conditions like light sensitivity (photophobia).
• Scleral shell. If you still have part of your eye, your provider may fit a scleral shell over your existing eye. This device is useful if you have a condition like phthisis bulbi due to eye damage.
• Conformer. A conformer is a temporary device that an eye care specialist typically uses after eye removal surgery. They fit the device in your eye socket to hold space and avoid scar tissue until you’re ready for a prosthetic eye.
• Orbital prosthesis. Your provider may use an orbital prosthesis if you’ve lost additional tissue like eyelids, eyelashes and eyebrows either due to trauma or a surgery called exenteration. This device is much larger and made of silicone to restore your natural appearance.

What happens when I receive a prosthetic eye?

Prosthetic eyes (ocular prostheses) need careful fitting and fabrication. There are several steps to the process:

• Eye tissue removal. Your ophthalmologist will remove any existing eye tissue. Options for this surgery depend on the amount of tissue you have left. Your provider may do an evisceration or enucleation.
• Tissue (socket) implant. This surgical procedure usually happens at the same time as the eye tissue removal. A tissue implant helps your eye socket maintain its shape. It leaves enough room for the prosthetic at the front of your eye socket.
• Conformer placement. Your eye specialist will also fit you with a small piece of acrylic plastic called a conformer. A conformer is placed at the time of eye tissue removal and is temporary. It supports the front of your eye socket and associated tissue like your eyelids until you’re ready for a permanent prosthetic.
• Healing. Eye tissue removal, socket implant and conformer placement can take weeks to months to heal.
• Wax impression. A healthcare provider who specializes in prosthetic eyes (ocularist) starts the process of fitting you for an ocular prosthesis. They make a wax impression of the front of your eye socket.
• Custom crafting. The ocularist carefully builds a custom prosthetic eye to match the shape, size, color and movement of your remaining eye.
• Painting. The ocularist paints a new iris and blood vessels on the white area of the prosthetic.
• Prosthetic eye placement. Your eye specialist removes the conformer and replaces it with the new prosthetic eye. They’ll show you how to remove it and put it back in.

The fabrication process can take days or even weeks. You may have to come in for several appointments to make and fit the ocular prosthesis before leaving with it in.

How long do prosthetic eyes last?

A good lifespan for an artificial eye is about five years, especially with regular cleaning and yearly polishing. But some prosthetic eyes remain in good condition and can last longer.

What are the potential benefits of prosthetic eyes?

The benefits of prosthetic eyes fall into two main categories: helping you feel better about your appearance and protective effects.

• Appearance. People missing an eye commonly experience anxiety, insecurity or fear when faced with unfamiliar situations or new people. A realistic ocular prosthesis can be the difference between dreading or feeling comfortable in social situations.
• Protection. A prosthetic eye and the underlying ocular implant help the tissue around your eye socket maintain its shape. The prosthetic is a barrier that protects your eye socket from foreign objects, materials or irritants.

What are the disadvantages or side effects of wearing a prosthetic eye?

The risk of complications from an ocular prosthesis is minimal when you maintain them as instructed and take the proper precautions like handwashing.

Some of the more common complications or side effects include:

• Eye socket discharge is common after having your eye removed
• Eye socket pain
• Turning outward of your lower eyelid (ectropion)
• Eyelid droop (ptosis)
• Infections of your eye socket or surrounding tissue
• Inability to fully close the affected eyelids (lagophthalmos)

How long will it take for me to get used to wearing a prosthetic eye?

Most people will get used to wearing a new prosthetic eye after a few days to a week. Your ocularist will generally recommend keeping your prosthetic eye in as much as possible, including while you sleep.

But getting used to an eye that feels new isn’t the same as feeling discomfort or pain. Tell your eye care specialist immediately if you notice discomfort or pain from a new ocular prosthesis.

Is there anything I can do to make wearing a prosthetic eye easier?

You can do several things to make wearing a prosthetic eye easier. They include (but aren’t limited to) the following:

• Clean the prosthetic eye exactly as instructed. Your ocularist will teach you how to do this and what to use. Using the wrong type of cleaner or solution could damage the ocular prosthesis. Your ocularist will polish the prosthesis periodically to reduce irritation.
• Wash your hands before handling the prosthetic. This makes it less likely that germs from your hands can cause an eye socket infection.
• Use artificial tears as needed. Adding artificial tear solution can help with the lubrication and comfort of wearing the prosthetic eye.
• Minimize handling of your prosthetic eye. Your ocularist will tell you how often to remove your prosthetic eye. It’s not like a normal contact lens. Most ocularists recommend removing it less than once each month. If you have problems leaving it in longer, discuss this with your ocularist.