Prosthetic eyes are usually made and fitted about six weeks after enucleation. The process involves four one-hour treatment sessions interspersed with laboratory processing:
At the first session, an impression is taken of the socket and a plastic button is trimmed to the diameter of the iris. The iris colours are matched directly to the patient’s natural eye and applied to the button using finest grade oil paints and the smallest of sable hair brushes. When dry, a clear acrylic cornea is processed over the top of the painted iris and an iris/corneal button is produced.
During the second session this iris/corneal button is imbedded into a wax pattern made from the impression and the whole is inserted into the eye socket. The wax is shaped and molded until the direction of gaze, the size and the lid
contour of the eye is established. After the session, a plaster mould is made and the wax is replaced with plastic (methyl methacrylate).
The third session involves colouring the plastic sclera with yellows, blues and grays and laying in fine veins teased from nylon thread. Once this is done a clear plastic veneer is processed over the surface of the prosthesis and finished off with a high polish.
The completed prosthesis is fitted in the fourth session and instructions on wearing and looking after the eye are given. If the socket or eye-lids are asymmetrical in some way the cosmetic result may often be improved with socket surgery.
The 5th and final session takes one month later when the prosthesis has settled in. Any final adjustments are carried out at this stage and questions about the prosthesis are answered. Advice about maintaining the eye and socket is repeated.
Fitting prosthetic eyes for children is a specialty of our practice. It is scary for little ones but the process is painless.