Ocular Prosthesis (Prosthetic Eye): Types, Care, Surgery & More

An ocular prosthesis, also called an orbital prosthesis or artificial eye, is a synthetic eye that is meant to mimic the appearance of a natural eye. 

It is common practice to install an implant and temporary conformer after any surgery that removes an eye. The conformer is replaced by a more permanent prosthetic after about a month.

The Basics of Orbital/Ocular Prostheses 

An ocular prosthesis is a device put in place of a natural eye that has been destroyed as a result of injury or disease. While current technology doesn’t allow the eye to see, it can help a patient’s face appear almost indistinguishable from someone with two working eyes. 

Ocular prostheses, commonly just called artificial eyes, are commonly made of plastic or glass. Most prostheses are designed to mimic the human eye in appearance, with most patients choosing designs that match their existing eye. However, some patients instead choose more unusual or striking designs. 

One of the most common alternatives to using an artificial eye that mimics one’s functional eye is choosing a prosthesis with a different eye color, giving the appearance of heterochromia (two different colored eyes in the same individual). 

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Reasons You May Need an Eye Prosthesis

Any scenario where the eye is destroyed or otherwise removed can warrant a prosthetic eye. Often, a patient has a non-functioning eye removed via surgery if it cannot be saved and poses any kind of health risk. 

A surgeon can use one of two procedures to remove an eye.

• Evisceration: During this procedure, most of the eye and its contents are removed, leaving only the white of the eye and connected muscles.
• Enucleation: During this procedure, the entire eye is removed. The related muscles then get resewn to the spherical implant. 

These are some of the most common reasons an eye might get removed:

• Injury
• Cancer
• Infection
• Significant eye pain, such as that caused by neovascular glaucoma

Who Is a Candidate for an Ocular Prosthesis?

Doctors take a lot of care when recommending a patient replace their eye with a prosthesis. It is a significant change and irreversible. 

Generally, people get prosthetic eyes only when a doctor cannot save the eye, or the eye is causing such discomfort that its removal represents an improvement to their quality of life. An eye affected in such a way often cannot see or is providing significantly limited vision.

Why Use an Ocular Prosthesis? 

The main reason people use an ocular prosthetic is aesthetic. Culturally, we attach significant value to the face and eyes specifically. A prosthetic can help maintain facial symmetry and make it much less obvious that a person is missing one or both functioning eyes.

It can make many social situations easier, especially for children. While there is something to be said about accepting different body types, especially those altered by circumstances outside our control, a missing eye is noticeable. Artificial eyes can help to limit awkward questions or glances that, fair or not, might otherwise be experienced. 

While it is not an absolute medical necessity, getting an artificial eye to replace a missing eye is standard practice.

Prosthetic Eye Surgery

The surgery to remove an eye is fairly quick, often completed within an hour. In the case of both enucleation and evisceration, an implant is put into the empty socket once a surgeon has removed the targeted material. 

The specifics depend on which surgery a person is getting. Because enucleation removes the whole eye, the muscles are sewn to the inserted implant. This doesn’t occur with evisceration because more material is left in the socket, including the sclera and attached muscles. 

A placeholder conformer is placed over the implant. This conformer serves a dual purpose. The first is to help with the healing process. The second is to sit temporarily where a more permanent prosthetic will be placed after about two months.

Recovery From Ocular Prosthesis Surgery

The recovery process after having an eye removed and a prosthetic put in place is less intense than many expect. You can expect some pain but not generally more than basic, over-the-counter painkillers can help you with. You may also get prescribed antibiotics or anti-inflammatories. 

For about a month, avoid any strenuous physical activity. Beyond that, you can usually begin living your life as normal once you feel ready. Assuming you can see enough to do it safely, you can resume driving and similar activities a few days after surgery.  

The most difficult part of recovery for many people is maintaining good discipline with their bandages. Be sure to follow all instructions given to you by your surgeon. 

The site may get itchy, but you should not remove bandages early without first contacting your doctor. The good news is most patients can remove their bandages within a day or two. 

If you experience severe pain or discomfort, contact your doctor as soon as possible as this isn’t normal. 

Your doctor will schedule a follow-up exam within one or two weeks. You can begin wearing a custom prosthetic once you have fully healed. 

Ocular Prosthesis FAQs

Can you see with an ocular prosthesis?

In the vast majority of cases, restoring a person’s vision after an eye is removed isn’t possible with modern technology. While research in this area is advancing and it seems like a completely plausible technological discovery to be made in the future, it isn’t presently possible. 

However, some early advances in that area have already been made. For example, researchers developed an artificial retina that now allows those blinded by the disease retinitis pigmentosa to partially regain sight. 

Bionic or cybernetic eyes that allow the total restoration of sight may someday be possible, but no accurate timeline currently exists for such advances. 

How much does a prosthesis cost?

Ocular prosthetics vary a great deal in cost. Ocular Prosthetics notes that prices in the United States vary from $1,800 to as much as $8,500. Insurance generally covers the cost of prosthetic eyes. High-end pricing is usually for luxury, highly customized eyes. 

Can you see with a prosthetic eye?

A prosthetic eye does not restore vision. If the entire eye is removed, an ocular prosthesis simply fills the space where the eye was for aesthetic purposes.

How long does an ocular prosthesis last?

Generally, an ocular prosthesis will last at least 10 years.

Does insurance cover a prosthetic eye?

Yes, in most cases, health insurance will cover the cost of a prosthetic eye. Vision insurance does not cover the costs.

References

1. Artificial Eye Care. UK NHS.

2. CFR – Code of Federal Regulations Title 21. (January 2022). U.S. Food and Drug Administration.

3. Enucleation. (November 2021). StatPearls.

4. Eye Removal Surgery: Enucleation and Evisceration. (November 2019). American Academy of Ophthalmology.

5. FDA Approves First Bionic Eye for the Blind. (February 2013). U.S. Department of Energy.

6. Neovascular Glaucoma. (November 2021). American Academy of Ophthalmology.

7. Evisceration in the Modern Age. (January–March 2012). Middle East African Journal of Ophthalmology.

8. Custom-Made Ocular Prosthesis. (August 2012). Journal of Pharmacy & BioAllied Sciences.

9. How Much Does An Artificial Eye Cost? (May 2021). Oculus Prosthetics.

10. Different Techniques in Fabrication of Ocular Prosthesis. (November 2012). The Journal of Craniofacial Surgery.

11. Ocular Prostheses in the Last Century: A Retrospective Analysis of 8018 Patients. (May 2013). Eye.