A new eye

By: Marissa Williams

For the 50 or so West Australians who lose an eye through injury or disease each year, the work of an ocularist can make all the difference.

Fifteen-month-old Riley Davies/Mele is about to have an adjustment for his prosthetic eye, first fitted after he lost his right eye to retinoblastoma (cancer of the retina) when he was only a few months old.

So how do you insert a prosthetic eye for a 15-month-old toddler wandering around the room?

Deftly and with ease, if the example of ocularist Jenny Geelen is anything to go by. In no time, she pops Riley on his mother’s lap, flicks his eyelid up and removes the prosthetic eye with a small suction cup.

Ms Geelen is one half of a brother and sister team of ocularists, who make and fit prosthetic eyes. The role is highly specialised with only about 10 ocularists working in Australia. There are no professional courses for ocularists and training is usually in the form of a job apprenticeship. However, ocularists have to fulfil certain requirements to join the Ocularists Association of Australia.

Ms Geelen has worked as an ocularist for 10 years. She learnt the craft from her brother, Paul, who in turned learnt from their mother. “We often had prosthetic eyes lying all over the kitchen table,” laughed the brother-and-sister team. “Mum would bring them home to work on them,” Ms Geelen said.

As a schoolboy, Mr Geelen had already made up his mind that he wanted to become an ocularist. He did work experience in dental prosthetics because the material used to make prosthetic eyes is the same as in dentures. He then trained as an apprentice under his mother. Though nothing diminished the tragedy of losing eyesight, Mr Geelen said he felt the work of ocularists helped heal a little of the patient’s trauma. “We help make people feel whole again,” he said. “They can look in the mirror and feel normal again. I believe it’s important and satisfying work.”

The prosthetic eye is more like an extra big and extra thick contact lens – with an amazingly realistic pupil and iris painted over. This lens fits over a round ‘eyeball’ made of coral or acrylic which surgeons insert during an operation and cover over with the patient’s conjunctiva.The eye’s colour and shape are matched with the patient’s remaining eye, down to the last blood vessel. Riley’s mother, Amee, was thrilled at the realism the pair could achieve.

“We were not sure and we just thought it would be a marble whacked in there,” she said. But Riley’s prosthetic eye looked so natural most people thought he had a lazy eye or did not even notice anything unusual at all, she said.

Making prosthetic eyes is a careful and detailed process, with patients coming in for five visits in a week. The Geelens take an impression of the eye socket, cast the mould and then embed the false iris before painting the pupil and veins and tinting up the sclera, the white of the eye, to the right shade. They then put clear veneer across the eye and fashion the curvature of the prosthetic to match the other eye. At each visit, more adjustments are made until the prosthetic is just right.

There was a great deal of artistry involved in painting realistic prosthetics, the pair said. “Every eye is different. It doesn’t matter how long you have been doing this. Every eye is a challenge,” Ms Geelen said.

But Mr Geelen said even more important skills were empathy and patience. People were often dealing with a range of emotions after the trauma of losing an eye and the ocularist had to be sensitive to their needs.

In 15 years in the profession, Mr Geelen has heard just about every horror story involving eye loss. When he first started, car or industrial accidents were often to blame. But the advent of seat belts and safety glass had cut that rate dramatically and today, the most common cause was eye cancer.

Prosthetic eyes last many years, though adjustments are needed to accommodate changes in the eye socket. Patients can swim, sleep and do just about anything while wearing their eye.

The Geelens make and fit about two to three prosthetic eyes a week. Each eye cost about $1,500* but, given the amount of time they put into making and fitting each one, it was certainly a profession that they did out of love rather than money, they said.

*Edited to 2006 price