The process of custom making an artificial eye for an individual child involves several stages.
The mould may be made during an EUA, while the child is asleep. Making it when the child is awake often has a better cosmetic result.
A wax impression is made from the mould, then a plastic insert that will become the artificial eye. The Ocularist will then create the eye, painting it to match the real eye.
Making the Mould
In the first step of the eye making process, the ocularist places a special “plunger” into the child’s eye socket. This looks like a suction-cup arrow found on children’s toys. Your child will feel a strange but painless sensation from his eyelid resting on the portion that sticks out.
Getting used to the unusual sensation takes a few seconds. If well supported and prepared, your child will adjust as soon as he realizes the plunger doesn’t hurt, it just feels odd.
Next, the ocularist inserts a soft mould-making material through the plunger into the eye socket (see picture 2). Again, this doesn’t hurt, but does feel weird. Your child must sit for a couple of minutes while the mould sets.
Psychologically, this is the most difficult step because the sensations are so unfamiliar. When the ocularist removes the plunger and mould, the sensation is gone. This entire process should take about five minutes.
Making the Impression
The mould is used to create a wax impression similar to the cavity in your child’s eye socket. The ocularist places the impression into your child’s socket to see how it feels. Your child may not feel some parts of the impression, while other parts will cause pressure inside the socket.
Encourage your child to tell the ocularist which parts are causing pressure. He will then remove it, make it smoother, and reinsert it.
The ocularist will smooth and reshape the wax until the impression is the right shape. The eyelids must rest on it comfortably when the eye is open, and close properly when blinking. The ocularist shapes the wax to fill out certain areas around the eye socket so the eye has a natural look.
The impression may be inserted and removed several times during this process. This is not painful, but your child’s eye socket may become a little irritated. Sometimes this is due to the in / out action, and sometimes due to the lubricants used. Switching to a heavier silicon lubricant can ease irritation. Discuss this with the ocularist.
When the wax impression is properly fitted, the plastic insert will be made. This is a plain white piece of plastic the same shape as the wax, and takes about an hour to make. The ocularist will need to insert and remove this from your child’s eye socket several times.
Painting the Eye
Once you, your child and the ocularist are satisfied with the insert, he will draw on the insert how the eye should be aligned. He will then remove the insert to begin making the “eye”.
He will drill a hole in the plastic and insert the coloured area. This resembles a button, very close to your child’s own eye colour. The ocularist may ask your child to sit next to him as he paints the special eye, looking closely at your child’s remaining eye as a guide.
When painting is complete, there is a final fitting, then your child is done!