Prosthetic eyes are necessary in children for the following reasons:
Initially, a custom piece is individually molded and shaped for volume and matching lid contours. Using alginate, a creamy material, a basic mold is placed behind the eye lids while warm to conform to the patient's unique shape. This shell is worn for a few weeks to help the patient adjust to wearing the artificial eye. The above procedure is only used for people with misshapen or shrunken globes.
The general procedure for creating an artificial eye is as follows:
- Using alginate, a primary mold of the eye is made by putting the material behind the eye socket and letting an impression set.
- After removal, a two-piece mold is made, very hot wax is poured into the mold. The wax is used as a base for creating the eye, as it is malleable. Further shaping and adjustments canbe made as necessary.
- Doctor and patient choose an iris, pupil, and cornea of the front of the eye that most accurately match the working eye. Some ocularists paint the iris on by hand. The above can be positioned as needed for most realistic gaze and dilation. This part takes a few hours due to constant trial and error and refittings.
- The sclera, the outer white coat of the eye to which six muscle groups outside the eye that hold the eye in are attached, is painted in and color adjustments are made. Very thin red threads are placed on the mold to recreate small veins on the sclera. The tear duct is also painted on the mold.
- The eye is shaped for eyelid fittings identical to those of the other eye (older versions of the eye had a bit of a problem in this respect). The mold can be augmented and shaved down for desired effects.
- Once the eye is deemed finished, the eye is put in the original mold and sealed with an acrylic finish. This finish gives the eye a shine mimicking that of the liquid that constantly bathes the eye. This maintains the integrity of the iris' color and the painting of the veins and sclera. It also provides comfort and allows for greater mobility.
They claim this doesn't hurt. They are lying. When you are four years old and someone is sticking a warm and unfomfortable piece of plastic into your eye socket, it hurts. I'm sure that my mother did not enjoy having to hold me down during this. Also, considering that some appointments last upwards of three hours, you get awfully squirmy. Mobility depends on the quality of fit of the eye (I have 20-25% mobility, which is enough to trick about 95% of the population).
You get adjusted to wearing your eye just as you do wearing your contacts. You wear it during waking hours and remove it at night and let it soak in a diluted soap mixture with warm water. Lately I have found that two drops of Dr. Bronner's Pure Castile Soap mixed with warm water in a small cylindrical pill bottle works very well. After a while, you remove the eye once a week, twice during allergy season.
When touching your eye, you must sterilize you hands as best as possible to prevent later infections (I recommend Neutrogena Oil-Free Soap). Artificial eyes are hard to break, but this is not an excuse to have butterfingers when dealing with them (another reason to make sure your hands are degreased). While your eye may not break, it will get surface scratches and you will eventually have to go to your ocularist to get it polished.
When you are little you can expect to get a new prothesis every year (at least). After your 13-15th year, replacements will only be necessary due to losage, color fading, etc.
Artificial eyes can be lost when put under pressure. People have lost them when diving into lakes and pools. If you rub your eyes too hard it can be pushed out of its socket. Losing your fake eye is a really bad idea because they cost upwards of $700 (many insurance policies will cover them as an aesthetic enhancement).