Specializing in Custom Artificial Eyes

Ocular Prosthetics - Scleral Shells - Pediatric Prosthetic Eyes

Christie Erickson, BCO Licensed Ocularist
Todd Cranmore, BCO, BADO Licensed Ocularist

HOW CUSTOM OCULAR PROSTHETICS ARE MADE Making an ocular prosthesis involves a number of complex and carefully planned steps to result in a prosthesis that is life-like and as anatomically similar to a natural eye as possible. The below steps outline our process:
ARTIFICIAL EYE	CLEAR CONFORMER
Our custom ocular prosthetics are hand crafted from a fine medical grade acrylic in our office in Kirkland, Washington. We specialize in custom artificial eyes and scleral shells, otherwise known as ocular prosthetics.	The first step in fitting an artificial eye or scleral shell is to fit a clear acrylic conformer. This conformer fits inside the eye socket and opens the eyelids, so that both eyes are equal in shape and in overall appearance.
ALGINATE IMPRESSION	CAST OF IMPRESSION
The second step in the process is to take an impression of the eye socket, allowing a comfortable and exact fit. The impression allows us to match the volume and lid contours of the fellow eye and also allows for excellent movement in the final prosthesis.	The impression is then duplicated within a material called Castone, inside a stainless steel cast. This cast is used for making the white acrylic blank that will be the base of the prosthesis. The white blank is then processed using our specialized acrylic processor.
IRIS PAINTING	LATHE CUTTING
All painting is done by hand with acrylic pigments in our specially designed paint room. The iris is painted on a flat acrylic disc, layer by layer. We use advanced techniques combined with careful attention to detail to create a realistic and accurate match. This is one of the most important steps in perfectly matching a prosthesis to one's existing eye.	Once the iris is painted, a clear acrylic dome, similar to a cornea, is added over the painted surface. This dome brings up the depth and magnifies the detail of the iris. A specially designed lathe is used to cut a series of angles into the clear acrylic cap, allowing for a precise machined blend between the painted iris and the sclera portion of the prosthesis.
WHITE BLANK	POSITIONING IRIS
This white blank is the exact size and shape of the molded clear conformer. It will be fit for comfort, lid size and shape, and movement. A well fit ocular prosthesis will move (track) right along with the implant which is attached to the ocular muscles.	While the patient is wearing the white blank, the iris position and plane are marked. This step ensures that the position of the completed prosthesis will match the natural eye. The completed iris and positioned blank are then prepared for attachment.
ATTACHING IRIS	PREPARATION FOR VEINING
The iris is attached with an acrylic glue at the exact plane and position illustrated. This perfect line-up is very important for the finished overall cosmetic result.	The excess acrylic and positioning lines are then trimmed away, leaving a white blank with attached iris. The prosthesis is now prepared for the veining!
VEINING	COMPLETED VEINING
The veining of the sclera (white of eye) is done with a frayed red silk thread. This thread is carefully applied to match the veins on the natural eye. This step is done in our color-corrected paint rooms.	Once the veining is applied, the sclera is carefully tinted with our acrylic pigments to match the surface patterns and colors of one's existing eye. Notice how natural and realistic the eye looks at this stage.
ACRYLIC CAPPING	FINAL ADJUSTMENTS
After the veined prosthesis is allowed to completely dry, a final cap of clear acrylic is applied. This final cap seals in all of the veining and pigments and also provides the prosthesis with its final polished surface. The prosthesis then ground to the correct shape.	The prosthesis is polished with pumice, leaving a smooth durable finish for patient comfort. Following the polish with pumice, the prosthesis is finely polished with a high-speed wheel to remove all scratches and give it the final shiny finish.
COMPLETED PROSTHESIS	COMPLETED PROSTHESIS
The final prosthesis is then fit, adjusted and evaluated with the following seven considerations: 1. Size and lid contour 2. Proper posterior fit over the anterior tissues in the ocular cavity for comfort and motility 3. Color of the sclera (white) 4. Position and plane of the iris 5. Color of the iris and pupil size 6. Movement of the artificial eye 7. Patient comfort and a pleasing cosmetic result.	The entire process of making a custom ocular prosthesis takes approximately 3-4 appointments, which can be done over the course of one week depending on one's schedule. We try our best to be flexible to out-of-town patients. It is sometimes possible to complete an eye over 2-3 days, give us a call for more details. We hope you enjoyed your tour of our process, we look forward to serving you soon!