Discover the process we use to create ocular prostheses that are comfortable, beautiful and appear to be living tissue.
I am frequently asked to indicate to a doctor or patient something about my acrylic eye fitting methods. I am more than happy to do so. There are several successive steps which I shall briefly describe here.
Adequate healing is required before fitting the acrylic eye. Schedule; permitting, I will fit the prosthesis six to eight weeks after surgery. Upon arrival at my office, the patient will complete a medical history form; which is the beginning of a record similar to any kept by a medical office.
1 – An impression of the shape of the space of the eye socket is taken with alginate, which gels in about 15 seconds to the consistency of the white of a hard boiled egg. Any discomfort to the patient is minimal. After removal from the eye socket, a two-piece mold is made using dental stone, a material very much like plaster of paris, around the impression.
Taking an impression affords me the opportunity to design an eye which provides total comfort in most cases and much improved motility. No more removing the eye several times a day, or even once a day. No more mopping up spilled mucous from the socket! No more red, painful tissue.
2 – After the dental stone has hardened, the impression material is removed. Molten wax is then poured into the mold and allowed to cool and harden. Upon removal from the mold, this wax piece constitutes a pattern (for the artificial eye) which can easily be changed in shape to improve the appearance and comfort to the wearer.
An acrylic iris-cornea, which approximates the patient’s own iris, is chosen and designed into the wax pattern. It can be removed and placed in a different position in the pattern in order to provide the proper direction of gaze, vertical and horizontal positions, the desired prominence to the artificial eye, and to provide the proper eyelid opening. This part of the fitting procedure can take as much as several hours, during which time the patient must remain available at ten to twenty minute intervals for trial fitting.
3 – When all the improvements havebeen made in the wax pattern, a new, final mold of that pattern is made, using dental stone, in a brass flask. The wax is then removed; however, the iris cornea is placed back into the mold in precisely the same position it had occupied in the wax pattern. A dough of white acrylic is then packed in the mold and processed under heat and pressure until properly cured.
4 – As soon as the eye is processed, an amount of the acrylic is removed from the front surface in preparation for the coloring. Veins (fine fibers of red embroidery thread) are then painstakingly placed over the surface of the prosthesis in such a manner as to duplicate the veining pattern of the companion eye.
The actual coloring of the eye is done with the greatest care to match the companion eye and to present an appearance of living tissue. This is done by a method devised in October 1976 and used exclusively by those few discriminating ocularists who employ the Modified Impression Method of making artificial eyes. The patient must be present for this part of the work for perhaps two or more hours. At intervals, the prosthesis being painted is placed within the patient’s eye socket, then removed and the coloring altered. This step is repeated using a special clear painting lens until the coloring is fully satisfactory.
5 – When the color is judged to be correct, the eye is returned to the final mold and a layer of transparent acrylic is cured on its front surface to protect the color during polishing and wearing. The finished, highly polished prosthesis is then placed in the eye socket and evaluated in all aspects. If it is not correct in every way, changes are made until it meets my quality standards.