Frequently Asked Questions:
does my child need an ocular prosthesis after an eye loss?
are four reasons to wear an ocular prosthesis: Comfort,
Cosmesis, plus continued Bony Orbital Wall, and Eyelid development.
The first two reasons are of immediate importance for parent
and child. Comfort is gained with a properly fitted
prosthesis, (by relieving the physical stress caused by eye
volume loss, and drooping of the eyelid). Cosmesis
is recaptured with a lifelike appearance that is once more
acceptable to you, your child and peers. The other
two reasons are directed toward your child's formative years.
An adequate sized prosthesis is required to maintain near
symmetrical bony orbital wall and eyelid development.
child was born with a partially developed (microphthalmic)
eye, is it possible to fit a cover shell prosthesis over
such a globe?
a moulded cover shell prosthesis can be fitted over any stage
of microphthalmos. The early stage of microphthalmos
may require a series of moulded clear acrylic trial shells
to gradually enlarge the palpebral fissure (eyelid margins)
before a prosthesis can be fitted.
it be difficult for my child to be fitted with an artificial
and No. Each child is different in mood, personality,
disposition and what they have gone through prior to this
referral for an artificial eye. We can only determine
this during the initial evaluation. As with all patients
we want to take an impression moulding of the cavity.
This is not a painful procedure, but we do require the child
to be relaxed (as possible) and not squeeze the eyelids.
This impression will allow us to 'read' our duplicate copy
of the socket and prepare a prosthetic model for trial fitting.
If this is not possible, we would request an EUA (Examination
Under Anesthesia) where your child would be anesthetized
for less than 10 minutes. This is usually done on an
out-patient basis at a local hospital: (Children's Hospital
or Mass. Eye & Ear Infirmary). Your presence during
an EUA is welcome.
is the process of getting an ocular prosthesis for my child?
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.
what age should my child begin to wear an ocular prosthesis?
this is a congenital anomaly, born without an eye(s) or a
partially formed globe(s), there would be a preparatory stage
of plastic conformers 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 be 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).
If on the other hand, this is an acquired eye loss due to
disease or trauma, we would begin the fitting of an ocular
prosthesis in four to six weeks post-operative.
I need to find a pediatric ocularist or any ocularist will
board certified ocularists have been trained to fit any and
all age groups. We are, however, located in the City
of Boston that has a number of eye research and teaching
hospitals specializing in congenital birth defects and childhood
eye diseases. Therefore, our case referrals for children
under the age of 5 years would surpass that of other ocularists
in other parts of the country.
sensitive are the tissues under the eyelids when you put
the prosthesis in?
tissue sensitivity is similar to you putting a piece of hard
candy into the mouth (between the teeth and cheek).
it difficult for my child to adapt to wearing the prosthesis?
is amazing how quickly a young child can adjust to monocular
vision and the wearing an artificial eye, as compared to
the adult prosthetic eye wearer who is readjusting from a
lifetime of having depth perception. It becomes a second
nature to a child, and they are quite uninhibited.
We have parent and teacher stories of children removing the
prosthesis during 'show and tell' in school, or when complimented
by strangers about how pretty their eyes are.
do I help my child care for the prosthesis?
hygiene care instructions will be given upon completion of
the prosthesis, plus we will demonstrate the daily maintenance
and periodic removal care. Also, copies of the instructions
are available on our Procedure
do I help my child to remove and reinsert the prosthesis?
our laboratory, we will demonstrate removal and reinsertion
upon completion of the prosthesis. We also have "printer
friendly" instructions available on our Procedure
there any cautionary advice you can give regarding the prosthesis
and my child?
during your child's teething stage, we have had reports that
he/she will 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!