In most cases after the eye has been removed, the lost volume is partially replaced with a
silicone, plastic or integrated implant. With some of the implants available today the eye
muscles can be attached to the implant thereby transferring motion to it.
This simply means
that when you move your normal eye, the implant moves with it as well. Following the implant
placement a thin layer of pink tissue called conjunctiva is sutured over it so the implant is
not seen after the surgery.
The artificial eye fits over this buried implant and is not sutured into the socket in any way,
but is held in place by the eyelids. This allows your artificial eye to be remove for cleaning
as needed, and in some cases depending on the implant use, the motion of the implant will transfer
movement to the artificial eye.
However, unless the artificial eye is directly attached to the
implant, by way of a motility support peg fit by the ocularist, it generally will not move as well as the
normal companion eye.
Integrated implants like the Bioeye or Medpor Implants can be directly attached
to artificial eye by way of a motility pegging system. This is accomplished
by placing a motility peg made of titanium or plastic into the implant sometime after
surgery, (usually about six months) and then providing a corresponding cavity in the
artificial eye for the peg to fit into.
In addition, pegged artificial eyes provide
more support for the lids and reduce lid lag, which often is a problem for many patients
as they grow older.
If you do not have, or plan to
have a motility pegged attached following
suggestions can help make
the presence of an ocular prosthesis less obvious:
1. Most artificial eyes will not move up and down as well as the companion eye. Therefore,
avoid tilting the head downward while simultaneously looking up.
2. Many artificial eyes will have restricted motion to the sides (horizontally and nasally).
To compensate, develop a habit of turning your head, rather than just the eyes
in the desired direction of gaze. It also helps to develop a habit of closing
yours eyes just before you turn your head, and then reopening them afterward.
This little trick becomes second nature after some practice.
3. Selecting eyeglasses with a rather heavy frame will often help divert attention from
your eyes and will help cover upper any lid depression, (Sulcus) if present. Tinted lenses
will sometimes improve the cosmetic effect but should not be so dark as to interfere
with your night vision.
4. Also make sure you ask your
optical professional for Polycarbonate lenses when ordering the glasses.
Polycarbonate lenses are extremely impact resistant and provide the
greatest degree of safety compared to any other lens material. When you have only one eye,
it just makes good sense to protect it.
  Don't take chances...Protect Your Remaining Eye
With High Impact
Polycarbonate Lenses, the safest material available.
5. Using special optical power lenses in
eyeglasses worn over prosthesis can create an optical illusion. It
is possible to widen or reduce the lid opening or change the apparent lid shape.
Do not agree to a "non-balanced" lens over the artificial eye because any
difference in lens style will draw attention to it.
Even
though it may cost a little more money, make sure the lens style (i.e. bifocal, trifocal)
and power are the same as the other lens or that it is specially designed to provide a better
cosmetic appearance.
6. One last thought: Remember when people without
an artificial eye, talk to each other, it is normal for them to choose an eye to
make visual contact with. Most people will also shift their gaze back and forth
between the eyes while talking. If you feel someone is concentrating his or her
gaze on your artificial eye, you should not be too concerned.
This usually means it is the eye they have selected to talk to and not necessarily because
they have noticed any difference in your appearance. Most patients tell us, that when they
share the fact that they wear prosthesis, the reaction from that person is, they cannot
believe it.