This information has been drawn together in consultation with ocularists and ophthalmologists throughout the globe and should be used as a guide only. Individual circumstances may require a personal consultation with professional in your area.
Why does my child need an prosthetic eye after an eye loss?
Although an ocular prosthesis does not have vision of its own, a prosthetic eye is medically necessary for many reasons, the most common are: 1) enabling a sited-companion eye to see and function better by eliminating negative symptoms of sympathetic-opthalmia (the condition where the health of one eye / eye socket either helps or harms the health of the companion eye / eye socket), 2) eliminating physical stress caused by facial imbalance of the eyelids (comfort), 3) eliminating the recurrence of chronic infection characteristic of a compromised eye socket, 4) halting anatomical asymmetry and disfigurement by inhibiting the skull and surrounding tissue from migrating into a recessed eye socket and, in the case of a child, enabling the skull, sinuses and facial tissue to grow proportionally and properly, and 5) the most obvious medical benefit to patients and parents of pediatric patients is the restoration of natural facial anatomy.
Will it be difficult for my child to be fitted with an artificial eye?
The answer to this greatly depends on the temperment of the child. Each child is different in mood, personality, disposition and what they have gone through prior to proceeding with fabrication of an artificial eye. As with all patients, an impression molding of the patient’s eye socket needs to be taken. This is not a painful procedure, but the child is required to be relaxed and cooperative, not squeezing the eyelids. If this is not possible (and it usually is not for young children), the the impression must be taken during an “EUA” (Examination Under Anesthesia). During this appointment your child will under anesthesia for as little as 15 minutes. This procedure is usually done on an out-patient basis at a local hospital.
My child was born with a partially developed (microphthalmic) eye, is it possible to fit a prosthesis over such a globe?
Yes, and the proceedure is the same for a socket with no eye. Often thin ocular prostheses are called “scleral shell ocular prostheses.” These can be made to fit over any stage of microphthalmos. The early stage of microphthalmos may require a series of custom molded clear acrylic shapes (custom conformers) to gradually enlarge the orbital anatomy and palpebral fissure (eyelid margins) before a prosthesis that looks like and eye can be fitted.
What is the process of getting an ocular prosthesis for my child?
If this is a recent eye loss, you would be referred to an ocularist by your pediatric ophthalmologist, or primary care physician. Local, statewide and national healthcare insurers require this paper trail for approval of this service.
At what age should my child begin to wear an ocular prosthesis?
The steps to create a prosthesis should begin within a four to six weeks post-operative. In the case of a congenital anomaly (born without an eye(s) or a partially formed globe(s)) there would be a preparatory stage of custom conformers created in incremental sizes (in order to expand the eyelid margin and create space within the socket) prior to the fitting of the artificial eye. (This process can take anywhere from three months to three years, depending on the severity of the abnormal development of the bony orbital wall and the palpebral fissure aperture (eyelids).
How sensitive are the tissues under the eyelids where the prosthesis goes in?
The tissue sensitivity is similar to you putting a piece of hard candy into the mouth between the teeth and cheek.
Is it difficult for my child to adapt to wearing the prosthesis?
Young children can adjust to monocular vision and the wearing an artificial eye very quickly, as compared to adult prosthetic eye wearers who are readjusting from a lifetime of having depth perception. Wearing a prosthetic eye usually becomes a second nature to a child. If the eye was lost due to a trauma, it is the trauma that is far more difficult to adjust to then the acual wearing of the prosthesis.
How do I help my child remove and reinsert the prosthetic eye?
Your Ocularist will show you how handle the eye prosthesis. Instructions for removal and reinsertion can also be found on our website HERE.
Is there any cautionary advice you can give regarding the prosthesis and my child?
Yes. If your child is teething, be aware that they may remove the prosthesis and begin to bite on it (these small teeth marks can be polished off.) However, we also have had a few reports of children swallowing it. (If this occurs, you will have a diaper check, prior to having it disposed of or sterilized.) To date, there has been only one report in fifty years of a child choking on it where the Heimlich maneuver was applied.