Where can you usually buy an Artificial Eye? 
In the Philippines, there are two places where you can probably get an Artificial Eye. ​
​
The first is in an Optometrists or Ophthalmologist's office. Some eyecare practitioners carry ready-made prosthetic eyes in their offices. They're usually readily made, and all you have to do is pick among a group of Prosthetic Eyes which one fits you the most. ​

Most of the time, patients who needs an artificial eye would ask me things like "How does an Artificial Eye work?", or "Is fitting an Artificial Eye like having a surgery?", etc. Hopefully by the end of this article, I'm able to show how simply getting an Artificial Eye is, and that there is no need to be worried when getting a new one.

What is an Artificial Eye?
An Artificial Eye, or a Prosthetic Eye, is a type of prosthesis commonly used by people who lose their eye due to an accident or an eye disease. The Artificial Eye's primary function is to make it look like the natural eye was never removed.  

​In unfortunate events, children may also need to have their eyes removed. Same reasons with adults, it is usually an end-stage eye disease or because of a traumatic injury requiring to have their eye removed. Here are some things you need to expect on a child’s first prosthetic eye.

​1. The fitting process may be different than an adult. Sometimes, the child’s Ophthalmologist would agree to do the fitting of the prosthetic eye while on a General Anesthesia (GA).
In some cases, GA is not considered, and the usual trial and error fitting of a prosthetic eye is difficult, especially to children who are not cooperative.

2. A Child may need to visit the clinic more often for adjustments.As the body grows, so too should the eye socket. In the early years of wearing a prosthetic eye, parents may notice that the prosthetic eye maybe a little too loose. The ocularist may opt to adjust the size of the prosthetic eye. Adjusting the prosthesis helps the prosthesis to adapt to the changes in the tissues of the eye socket.

3. As the body grows, so should the Prosthetic Eye.As the body grows, particularly the facial area, so too should the prosthetic eye. An eye care professional may need to schedule appointments more often to perform more prosthetic eye adjustments. Enlarging the prosthesis will act as a stimulus to the eye socket to further expand its size.

4. The cleaning regimen will be taught to parents first, and then the child.Yes, wearing a prosthetic eye also needs cleaning. Cleaning the prosthesis and the lids of the child are essential to reduce the chance of infection in the future. Your eye care professional should discuss this routine after releasing the prosthetic eye.

​Losing a part of the body could have a significant impact on a child, especially those who are five years old and above. Many would feel the anxiety of not being accepted socially. It is up to their support group to show them that losing an eye can be overcome. It just gets lighter when there are people around the child to support them.

Dr Mark Paroli is a board certified Optometrist with a special interest in Orthokeratology and Ocular Prosthesis. He is an advocate of people with Low Vision and Myopia Management on children. 

​An Artificial Eye is a type of prosthesis used to replace a removed or damaged eyeball. 
It has two goals. The first is to aesthetically replace the removed/damaged eyeball to make it look like it was never damaged/removed. 2nd is to maintain the space of the eye socket where the previously removed eyeball is located. 

​Is it a Surgery?

No. The prosthetic Eye fitting does not include surgery. Surgeries are usually done before the fitting of an Artificial Eye, and patients would have to wait for another 2 to 3 months to have a prosthesis fitted to them. 

Dr Mark Paroli is a board certified Doctor of Optometry in the Philippines. He has special interest in Ocular Prosthesis, Orthokeratology, and Low Vision Rehabilitation. He is an Advocate of children with Low Vision and Myopia Progression Control. He Finished his Masters in Business Administration at the Ateneo Graduate School of Business. ​

​Almost all the countries in the world has been caught off-guard with one of the most infectious Viruses in history. Many economies have shut down, including the Philippines.
In fact, as of May 7, 2020, the Philippine's Department of Health has recorded a total of 10,343 cases nationwide, a 339 increase from the day prior, where 8,040 of them are considered as active cases. 

So, what does this mean for a person who uses a Prosthetic Eye, or an Artificial Eye?
With this data, a person who mishandles using an Artificial Eye in the Philippines may be at risk of transmitting or getting the virus. Here is why:

​The current understanding of how the Covid-19 works is mostly based on how most coronavirus works. It is believed to spread from person-to-person via respiratory droplets produced by an infected person, for example, when they sneeze or when they cough. 

Also, the virus may live on surfaces for hours. It may be transmitted to a healthy person when they touch a contaminated surface, followed by touching their face, particularly on one's Nose, Mouth, or Eyes. This is why the CDC and WHO recommend diligently washing and disinfecting a person's hands with Anti-Bacterial Soap or Alcohol.

​There will be times that a person who is using an Artificial Eye may need to remove their Prosthesis. Especially when they need to adjust their prosthetic eye or if it is time for their routinely cleaning. 
This mishandling may be risky for a person if they do not correctly clean both their Prosthetic Eye and their hands. 

​CDC and WHO have recommended of diligently disinfecting our hands to avoid any human-to-human transfer through the hands. Therefore, during the cleaning of the Prosthetic Eye, a patient should wash their hands with an anti-bacterial soap before and after handling their Prosthetic Eye.

When it comes to cleaning the Prosthetic eye, an anti-bacterial soap may also be used to disinfect the Prosthesis. Another good way to disinfect a Prosthetic Eye is via soaking it in a Contact Lens solution, particularly a Hydrogen Peroxide based solution, which is an effective Virucidal solution. One should remember to rinse the Hydrogen Peroxide solution properly before inserting it again in the eye socket.

Cleaning the surrounding may be beneficial to lessen contact with things that are usually touched (example, Door Knobs, Car Keys, Eyeglasses, TV remote, etc.). Soap, Alcohol and Chlorine bleach are effective tools to clean surfaces. To be specific, SARS-CoV-2 can be neutralized by lipid solvents including ether (75%), ethanol, chlorine-containing disinfectant, peroxyacetic acid and chloroform except for chlorhexidine. You may refer to EPA's website for a more complete list of disinfectants. 

I often tell my patients the Glitter principle, especially when handling their Ocular Prosthesis.
The glitter principle simply means the person should always imagine their hands being filled with glitters, and the rule is they don't want any of the glitters to get on any part of their face. To make sure that there is not glitters in their hands, they should often remove the imaginary glitters by washing their hands using anti-bacterial soap. This has been helpful in both my Contact Lens and Ocular Prosthesis patients.

Praying for everyone's safety! If you have any questions about Artificial Eye, you may email me at [email protected]

Reference:
​Beat Covid-19 today: A Covid-19 Philippine Situationer, Issue 11, May 08, 2020
www.aao.org/headline/covid-19-background-primer-ophthalmologists www.allaboutvision.com/conditions/coronavirus-and-your-eyes
Aaron Green, Chen Shen and Yaneer Bar-Yam, Coronavirus guidelines for cleaning and disinfecting to prevent COVID-19 transmission, New England Complex Systems Institute (April 9, 2020)

About the Author:
​
Dr Mark Paroli is a board certified Doctor of Optometry. He has special interest in Ocular Prosthesis, Orthokeratology, and Low Vision Rehabilitation. He is an Advocate of children with Low Vision and Myopia Progression Control. He Finished his Masters in Business Administration at the Ateneo Graduate School of Business. ​

Most patients who wear prosthetic eye experience some discomfort after a while. That is why it is very important to be aware of the different conditions or circumstances that may cause these discomforts. It is also important to know how to address them properly at the right time and with the right procedure. 
To make sure that it would be a little bit easier for patients and their families to remember the list of discomforts and the necessary steps to be taken to correct them, we will try to enumerate them by giving them one-by-one through the letters: D-I-S-C-O-M-F-O-R-T:

​Some instances dry mucous build-up roughly on the socket with a prosthetic eye. This happens if the patient's eyelids do not close completely over the prosthesis during sleep. It results in the accumulation of partially dried matter on the front of the eye as they wake up in the morning. A rolled-up tip of a quality facial tissue moistened with warm water can help in clearing this off. It doesn't need to remove the eye. Just make sure that you'll never use any kind of cloth because it can dull the surfaces of the eye.
It’s observable that patients whose eyelids that close completely during sleep can have a very slow building up of matter. It usually starts as a thin film that is difficult to see. But this can also make the surface of the eye a little bit rough and can irritate the underside of the eyelids as they blink. One can already suspect the possible presence of this thin film if the eye socket is irritated with scratching and itching or burning sensation. 
In this situation, it is very important to remove the prosthesis and carefully, but thoroughly, cleaned. 

A patient must always remember that the socket tissues around the prosthetic eye can also become infected the same way that the companion eye can be. Different bacterial and viral infections may happen. Discomfort and yellow/greenish discharge can be some of the indications of infections. The tear duct or drainage may be closed. In these instances, it is very important to consult one's eye care specialist for proper medications and treatment.

​There are some instances that that surface polish of the prosthesis is lost and some deep scratches happen. These can be the results of dust in the air that can get in the tear film and the scrubbing of the eyelids while blinking may reduce the polish of the surface of the plastic. This has happened to many patients. Sometimes when prosthetics drop onto hard and rough surfaces, deep scratches are left on the eye. Both of these can irritate the underside of the eyelids.
To correct this issue, the eye must be re-polished. It is recommended that prosthesis must be re-polished at least once a year. This is to maintain the comfort of the eye socket. This may reduce any potential discharge.

​Some patients have observed that when they have a common cold, they feel some discomfort. Mattering and some discharges from the socket of the prosthesis also happen while the other companion eye seems to be unaffected. It is very essential that during this period, removing the eye and washing it once a day may reduce the discomfort and discharge.

​Old plastic or prosthetic eye can accumulate toxic substances. This may develop after a long period.
Some prosthesis is made of acrylic plastic or Methyl Methacrylate Resin that has intermolecular spaces that are large enough for the passage of water molecules and may take up water slowly while it is being bathed or washed. Water may move continually and stay in the empty spaces. With this, viruses and some bacteria can grow into the eye. Evidence shows that proteins gather in the plastic and that these may bring irritation in the eye socket.
For some, polishing or even refitting won’t make them comfortable. The correction of this problem is simply to have a new prosthetic eye made of new plastic.

​A proper handling procedure is a must. It is very vital that prosthetic eyes are handled properly and taken cared of cautiously. If a patient or his or her caregivers do not have that conscious effort of taking care of the prosthetic eye and the patient's eye, most of the time irritations and discomforts happen. Bacteria and viruses, foreign matters and some other microorganisms that may cause problems may occur. 

​There will be some instances that foreign bodies will get into the eye socket of the prosthesis. Sometimes dust or other larger particles can enter into the eye socket. An eyelash can be carried into the socket while replacing the eye. When these happen, it can cause some discomfort and irritation. Thus, it requires removal and thorough cleaning.

​Opthalmitis or sympathetic Opthalmitis can be caused by the surgery made on the damaged eye. It harms the healthy aye following eye removal. It shows as an inflammation of the healthy eye. Although it is treatable, it can also lead to vision loss in a healthy eye. This may be caused by infection and if not treated properly it may cause some discomforts and may lead to a bigger problem for the eye socket of the prosthesis. This can be easily treated using antibiotic drops or oral antibiotics.

​House dust, animal hair, pollens from plants, dairy products, potatoes, and other foods may cause some allergies to some individuals. And sometimes may affect the surface tissues of the eyes without being aware of any discomfort. In this situation, it is very important to know the person's allergies by consulting an allergist and an ophthalmologist to have proper awareness of this.
Completely cured prosthetic eye which has been made-up of pure, medical-grade acrylic usually does not cause allergy. While there is no guarantee, perfectly fitted, fabricated and carefully cured prosthetic eye, is far from being a cause of allergies.

​It would be embarrassing for a person wearing a prosthetic eye would have some sudden discharges of large stale tears and mucous over the eyelid onto the face. Yes, sometimes it happens when the eye socket has accumulated tears and produced some mucoid discharges. This is caused by salts from the tears that irritate the tissues produce some mucus. Everyone must be aware that eye sockets of most persons change in shape slowly over time; due to the effects of the surgery, aging and fat wastes from the depths of its orbit. This results in pockets of space between the eye and the tissues, and if filled with tears and if collected it becomes stale or hard, thus, causing irritation and some discharges. 

​References:
Causes for Prosthetic Eye Discomfort. (n.d.). Retrieved July 23, 2019, from https://carolinaeyeprosthetics.com/causes-prosthetic-eye-discomfort/
Cirino, E. (2018, May 24). Prosthetic Eye: Cost, Care, Surgery, and More. Retrieved July 23, 2019, from https://www.healthline.com/health/prosthetic-eye
Post-Enucleation problems. (n.d.). Retrieved July 22, 2019, from https://chect.org.uk/resources-2/gp/post-enucleation-problems/

​Eyes are considered as one of our most important body parts. And the truth is, a larger part of our brain is dedicated to vision. Therefore, losing an eye is never a good situation. This is one of the unimaginable things a Filipino can ever experience. However, with the continuous scientific and technological research and advancement in the field of optometry, several options are already made available to help a person who's lost an eye. One of which is getting a Prosthetic Eye in the Philippines. It has brought a lot of benefits for individuals who decided to wear them. They even said that it changed their lives for the better. Because of technological advancement, wearing prosthetic eyes is now difficult to recognize because they have been made already amazingly natural. You will never know if someone is wearing a prosthetic eye if you don't know the person very well.
​
There are several personal benefits given by prosthetic eyes, however, the following are seven obvious benefits most wearers of prosthetic eyes will experience:

​It is true that having a disability is challenging. Especially if it affects a person's visual capacity. Other person's biases, judgmental stares, and rude and insensitive questioning make visually impaired individuals feel uncomfortable and make them hide their disability. That is why some of them who are missing an eye would result in wearing eye patches. But this makes them much more uncomfortable because their disability became more obvious. Other than that, there are no much options for individuals with eye disability, unless, they choose to wear a prosthetic eye.
The good thing is, nowadays, many individuals decide on having a prosthetic eye custom-made and fitted. This is in order to develop their appearance and make them look as normal as possible as the rest of the world. These prosthetic eyes are custom made by an ocularist who specializes in creating artificial eyes. It is interesting to know that most prosthetic eyes are made and composed of acrylic and the iris is hand-painted and usually based on the existing remaining eye of the new owner. The prosthetic eyes can be created a very close match with the other one and therefore can improve an individual’s appearance physically and at the same time giving them the confidence they definitely deserve.

​Prosthetic eyes do not only improve the physical appearance of the person wearing it. Since it replicates the eye that was lost, it balances facial features. Therefore it restores facial attractiveness. The prosthetic eyes, give an individual a much beautiful look. It helps in increasing the attractiveness of the person’s facial features.

​An enormous benefit of wearing a prosthetic eye is that it permits the body to function properly. Much more than the facial attractiveness and improving the physical appearance of a person with a disability, prosthetic eyes also helps a lot in the proper facial functioning. It is one of the favorable advantage or benefit of a prosthetic eye. It gives a person's body a chance to work properly. Based from clinical studies, if after losing an eye through surgery and a prosthetic eye is not immediately fitted and worn, the tendency is, the eye socket will begin shutting and the eyelid will be drained and start to stop working properly. 
On the other hand, if after an eye removal surgery and a prosthetic eye was immediately fitted and worn, the eye socket is given the chance to be on its great shape and normal size. Additionally, it also gives a person’s eyelid the chance to work accurately. The prosthetic eye is not just a way to complete a person’s appearance, but it is also an avenue to guarantee that the eye socket and rest of the eye structure continue to function properly and accurately. This specific benefit is not possible if a person is just wearing an eye patch.

​One of the very obvious effects of losing an eye is the issue of self-esteem. Having that feeling of lacking and being normal, many individuals who have lost an eye, or both, suffer from low self-esteem or confidence. It decreases their social interaction, opted to stay away from others and limits communicating with peers are just some of the manifestations of low self-esteem individuals. However, wearing a prosthetic eye that appears exactly like the other eye really increases a person's confidence and self-esteem. Wearing it makes them no longer appear to have a disability. Also, having a prosthetic eye that is so real-looking will definitely complete an individual's physical appearance like anybody else. It ‘hides' one's disability and makes people feel comfortable and confident on their own. Many of those who are already wearing artificial eyes would say that they become attractive again and feel that they are again "whole." This experience definitely boosts their self-confidence.
Additionally, having a prosthetic eye that bears a resemblance to the other eye will definitely build a person’s confidence. It is because it will not emphasize the fact that a person has an inability. The artificial eyes boost up the person’s confidence who don’t have an eye.

​Since losing an eye affects a person’s self-esteem or self-confidence, it definitely affects their totality as an individual. This is caused by unfair treatment, inconsiderate and insensitive treatment of strangers to those who have lost an eye or both eyes. It sometimes drives them to question their own identity and loses their own worthiness. However, many studies have already stated that wearing a prosthetic eye show several signs of improvement in a person's identity. They regain their own worth as an individual as they recover their confidence in doing things in society. They become a better person after wearing a prosthetic eye. 

Lastly, since the fitting and wearing a prosthetic eye builds or rebuilds self-esteem and self-confidence and makes an individual's personality a better one, it will definitely demonstrate in a person's social well-being. They start again to communicate and attend social functions and become a more productive member of society.
Although Prosthetic eyes are not designed to restore ones impaired or lost vision, its enhancement on a person’s appearance and the rebuilding and improvement of his or her emotions is surely guaranteed.

​References: 
Benefits of Prosthetic Eyes. (n.d.). Retrieved April 23, 2019, from http://www.waterdownoptometric.ca/view/article_4.3conx 
Benefits of Wearing a Prosthetic Eye. (2018, December 19). Retrieved April 23, 2019, from http://www.seocularists.com/2018/08/30/benefits-of-wearing-a-prosthetic-eye/

​The eyes are one of the most important parts of every one’s body. It is actually the most highly developed sensory organs. However, there are some times that man tend to take eyesight for granted and eye problems develop that may lead to surgery and eye removal. However, there are already several available eye treatment and surgeries that one may choose when time comes that there’s a need for it. Enucleation and the use of prosthetic eyes are just some of them.

​Enucleation is the surgical process of removing the entire eye which may be due to a severe injury or pain to the eye, tumors, infection, last stages of glaucoma, or cancer in the eye while the muscles and tissues that surround the socket are kept intact. After the surgical process, the individual is provided with an artificial or prosthetic eye which will be used to replace the eyeball that was removed. In most cases, the prosthetic eye is attached to the eye muscles in order to preserve eye movement which helps make the artificial eye look natural. Enucleation becomes necessary for an individual especially when he or she feels severe pain in the partially or completely blind eye because of the diseases or illnesses mentioned. Taking the surgical process would treat particular eye diseases and alleviate the pain in a patient's eye. It would also improve the quality of their life greatly (Kelly, 2018).

​Valeshabad (2014) found out that relatively, pain in the blind eye is the most common indication of surgery which is followed by leukocoria and endophthalmitis. His study also stated that the main types of injury include accidents in the road or work, firecrackers, and injury from sharp objects. The surgery is mostly done under general anesthesia wherein it helps the patient to not feel any pain during the procedure. After the surgery, a conformer is positioned behind the eyelids. This helps to keep the shape of the eye even after surgery. A stitch is then made to hold the eyelids together for a few days. The artificial eye will replace the conformer in a few weeks time just after the surgery on the eye has sufficiently healed. During the healing process, the conformer may start to fall out in the first few weeks. The conformer could be replaced but the patient must make sure that it is cleaned with soap and water before being placed back in between the eyelids. 

​Every surgery has its own effects. The patient may feel a headache, nausea, or eye pain in one or two days after the surgery. The doctor will prescribe the patient with pain-relieving medicines to help the patient in the discomfort he or she will be having after the surgery. Once the surgical wound has healed, a follow-up visit is done by the patient. The eye doctor will then remove the conformer and replace it with an artificial eye. A topical antibiotic is given which should be applied to the wound several times for the following few weeks.

​The prosthetic eye will give the patient benefits compared to deciding to not have one. These benefits include increased self-esteem, physical appearance, and proper facial function. The eyelids after a surgical procedure would most likely close in on itself which is why it is recommended for a prosthetic one to be placed. It helps maintain the eyelid movement as well as the shape of the eye. Without the artificial eye in place, the eyelids would not function properly. Also, most of the patients who have undergone enucleation suffer from self-esteem issues. They are afraid that the way people used to look at them will change. A prosthetic eye will help make their appearance look natural as the artificial eye is crafted and designed based on the other remaining eye. A patch most frequently makes them feel like they are different from the rest. With the prosthetic eye, however, there isn't much difference in their appearance ever since before they got an eye surgery which greatly boosts their self-confidence. 

An artificial eye may last for less than 5 years. Within the third and fifth year of use, the artificial eye must be replaced because of the tendencies of the soft tissues to settle into the eye socket. There are certain things that can be done to take care of the prosthetic eye that the patient will be continuously using. When cleaning the prosthetic eye, rubbing alcohol or other chemical solvents must never be used. A contact lens cleaning solution either hard or gas permeable could be used. The prosthetic eye must also never be sterilized using heat. The frequent removal or cleaning of the prosthetic eye is not really something that is recommended. As long as the prosthesis feels comfortable to the patient, it should just be kept in place. However, there are certain times wherein mucous secretion within the eye socket makes the patient feel uncomfortable. It is then recommended for the patient to do a certain cleaning procedure on the prosthetic eye. It is also highly recommended to wear a pair of glasses which has shatterproof lenses. This is a great way of protecting the eyes in the case of a facial injury.
(See: ​Importance of professionally polishing your prosthetic eye)

Most of the patients who have undergone this surgical procedure are worried that it may affect their lifestyle. But, in fact, those who had undergone this procedure can even play sports. Specific safety glasses can be worn in order to ensure the protection of the eye which had undergone Enucleation. Patients can also do leisure activities such as swimming. However, it is recommended that goggles must be worn to preserve the life of the prosthetic eye and to avoid any damage. 
With today’s modern medical technology, the current prosthetic eyes are made look so much like a natural eye. That no one could tell the difference. It might only look like artificial if the eyelid is dropping a little bit which can only be noticed if it was observed by someone close-up. It may be hard for most patients to adjust because losing an eye greatly affects them emotionally. Patients who had a hard time dealing with the thought that they have lost their eye could consult a psychiatrist to help them cope with the situation and continue living the normal life. Having a prosthetic eye may not change or affect one’s lifestyle. However, it may affect the way the patient sees himself or herself as someone with a disability. It is important to provide options like that of a prosthetic eye.

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References
Valeshabad, A. (2014). Enucleation and evisceration: Indications, complications and Clinicopathological correlations. Int J Ophthalmol,7(4), 2014th ser., 677-680. doi:https://dx.doi.org/10.3980/j.issn.2222-3959.2014.04.17
Yom, K. H. (2018, September 17). Enucleation and Evisceration: What to Expect. Retrieved April 5, 2019, from https://webeye.ophth.uiowa.edu/eyeforum/cases/279-anophthalmic-socket.htm
Enucleation Surgery - Removal of the Eye » New York Eye Cancer Center. (2016, June 15). Retrieved April 5, 2019, from https://eyecancer.com/eye-cancer/treatments/enucleation-surgery-removal-of-the-eye/
Losing an Eye: Enucleation and Prosthetic Eye FAQ. (n.d.). Retrieved April 5, 2019, from https://www.allaboutvision.com/conditions/enucleation-prosthetic-eye.htm
Prosthetic Eye (Ocular Prosthesis): Surgery, Care, Types. (n.d.). Retrieved April 5, 2019, from https://www.webmd.com/eye-health/prosthetic-eye-ocular-prosthesis#1

I have recently updated my works about Artificial Eye, patients I did in my clinic in SM City Clark, Pampanga, Philippines. 

In this post, we will be discussing the 7 Life Cycle of an Acrylic Artificial Eye, from the time it's fitted by your Ocularist, up to the time when it needs to be replaced. 

A Professional will then start to create an Artificial Eye. It usually begins by getting the Shape of your Eye Socket. Usually started by injecting an Impression paste on the inside of the eye socket. ​

The Prosthesis is finished and is made sure that scratches are absent during the fitting. ​

Your Doctor will ask you to do a follow up to check the surrounding tissue after you’ve been using the Artificial eye for quite some time. Questions like did you experience any problem, or did the eye rotate, may be asked to the patient. 

Throughout the years, changes may occur on the tissues of your eye socket, which will affect your Artificial Eye experience in many things such as Rotating Eyes or Misdirected Eye, or in some cases irritated Eye Sockets. Kids do need to change their Artificial Eyes more often than Adults.