Frequently Asked Questions
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What Is a Corneoscleral Shell Eye Prosthesis?
It is a custom made artificial eye, which fits like a very large contact lens over the top of a shrunken, disfigured and/or deviated living eye. The shell will be perfectly sized and shaped for maximum comfort and movement. It will be as thick as it needs to be to open your eyelids properly again, and we will paint your iris in the position that is necessary to be “looking” straight.
Who Can Wear These Shell Eyes?
Almost anyone who has a blind eye that is not painful and is not oversized compared to their seeing eye. Over the 25 years we have been making these shells, we have found very few people who have not been able to tolerate them due to our expertise and care in the fitting process. On occasion we have made a shell with a clear pupil so that a person who has a disfigured eye and has some ability to see light or shadows can still see those things.
What Is a Clear Trial Shell?
We will check your living eye for sensitivity, and if necessary we will make you a thin, clear “trial” shell to help you build up wearing time until you can keep it on for most of the day. Then we will make the properly sized, painted corneoscleral shell.
What if I am Light Sensitive?
Some patients are sensitive to light, even though they do not have any useful vision in their eye. The shells we make are opaque, so in a light sensitivity case, an eye prosthesis can really improve a patient’s comfort level.
How Often should I have my Eye Replaced?
The average useful “life” of an artificial eye is 7-10 years. Although it has been shown that polymethylmethacrylate does not support organism growth internally, a plastic eye that is 7-10 years old has an acrid, burnt hair type odor when it is ground into, suggesting a deep protein buildup and a deterioration of the plastic. Some people’s eye sockets are less sensitive to the aging process than others, so they are able to wear their eyes longer without having infections and experiencing continuous mucoid discharge. For this reason, we find it impractical to revise an artificial eye that is older than five years old.
The fit of the prosthesis is also a major factor affecting useful life and comfort level. Most patients whose artificial eyes have been truly custom fitted, and especially those who have had their eyes re-lined at five years old will enjoy a much longer symptom-free period with their prosthesis. If, however, the prosthesis is not properly fitted, processed or polished, it will be miserable from the beginning. One problem with a chronically irritating eye is that it often causes the mucus membrane tissues in the eye socket to shrink and if left over a long period of time the eyelids will turn in, causing even more discomfort and disfigurement.
If you take a prosthesis out and there is a pool of mucus behind it, this is a good indication that the eye no longer fits properly. If you notice that the front surface of the eye is dull or has a scratch on it after it has been washed with soap and water, it needs to be re-glazed using our special wet polish procedure. It is therapeutically advantageous to have the eyes polished yearly.
How Can I Tell If My Existing Prosthetic Eye Needs To Be Replaced?
If your eye was not custom fitted, based on an impression, then you need a new eye so that you can experience the superior fit and comfort of a properly fitted eye prosthesis.
- Stand about 18 inches from a mirror and check the following:
- Does the prosthesis appear sunken or more recessed than your living eye?
- Does it appear too large or too small?
- Does the upper lid seem lower compared to your living eye, particularly when you are tired? The upper lid should cross above the pupils of both eyes at the same place.
- Does the artificial eye look in the same direction as your living eye?
- Is the prosthesis faded or discolored? Do you have more discharge than in the past?
- Is it scratchy and/or irritating? Does your eye feel “dry”?
- Finally remove the prosthesis and look under a good light. Determine if any portion of the surface is dull. The front and back should look very shiny. (It is recommended that the eye should be polished once each year to avoid irritation from a dull surface.
There are some situations which make it impossible to achieve the ideal results for a patient and most of the problems become progressively worse if aggravated by an artificial eye which no longer fits properly, or is in need of polishing. In these very challenging cases, we are often able to create an acceptable illusion with or without the use of cosmetic optics in the eyeglass lens over the prosthetic eye.