Through artificial eyes

Custom made Ocular Prosthesis Eyes:

By Lakmal WELABADA

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Eyes narrate many things in life. Many poets both in the Eastern as well as the Western world have written many beautiful verses about the `eyes’ of beauties. `Just like the pupil of her eye, a mother looks after her only child’; this was how they described the overflowing love of a mother... But! Does everybody get blessed to have `eyes’? Eyes play a big role in a human’s life as they attract you at a first glance.

Everybody is not gifted with perfect human organs. Hence, wigs, dentures, padded or skinny dresses and so on are being used to cover up their imperfections.

Likewise those who have deficiencies in their eyes too suffer silently for not having an alternative to look `ok’... “Artificial eyes cost a lot,” is the bewailing answer of many such disabled who have lost both or either of their eyes by birth or many other tragic circumstances.

B. P. D. Sunil Dayananda Wickremasinghe of Cosmetic Eye Laboratory at Douglous Fernando Mawatha, Chilaw reveals his revolutionary secret formula method to the public who shed tears for an eye. `Custom made Ocular Prosthesis Eyes’ is his solution for it.

“`Prosthesis Eyes’ mean manually made artificial eyes for those who have lost eyes by birth or later due to many reasons. As we use a denture when we lose teeth, we use this artificial `eye-cap’ to cover the eye area and to look near perfect,” says Wickremasinghe.

“This method is being practised in many countries. But only about 250 ocular technicians are in the world, as far as I assume. There’s no institution to train this as a method professionally. I did a two years research on this before I found the correct form,” claims Wickremasinghe.

An eye consists mainly of an eye ball (which fixes in the eye socket with nerves and tissues), Scleral (the white colour part of the eye), Cornea (the light circular shade of the dark part of the eye which differs in colour and dimension, from person to person) and the Pupil (the tiny round dark circle at the centre of the eye).

Due to many reasons people lose their eye sight, and in such times they have to undergo surgery to remove their eyes. There are two steps in surgical removal of an eye; Enucleation - the whole eye including the eye ball, Scleral, Cornea and Pupil are removed. Evisceration - removal of the damage part of the eye content.

“When the whole eye gets removed, a big eye socket would remain in the eye area. In order to cover this up, one would buy an artificial eye-cap and wear it as you do so with a denture. But what happens is, this eye-cap (which can be bought from opticians) would get pushed up giving an unappealing appearance.

The eye socket and eye-cap should be fitted very well, as otherwise the eye area would fill with a discharge often. Even some clients who come to us are unaware about it, until they remove it from their eyes.

Also an artificial eye would differ from one’s remaining eye due to its proportion, colour and the dimensional errors. When we make an artificial eye we try to make it exactly like the other remaining eye. Even if one has to wear two Prosthesis eyes for both eyes (in a case when both eyes are removed) both artificially made eyes should be fixed well in the eye sockets,” says Wickremasinghe.

“A client with an Evisceration can be given an eye-cap easily as his eye-ball remains inside, and only the outer cap (Scleral, Cornea and Pupil) have to be made. But, when it comes to an Enucleation, the eye-ball is also being removed.

In such circumstances, we have to install an eye-ball first,” he says. Acrylic plastic (synthetic formula used for dentures) or Hydroxyapatite (made of human bone powder) is used to make the eye-ball.

According to Wickremasinghe, the best formula is Hydroxyapatite as it is however, an extraction of another human body, and is believed would get adjusted better with the remaining tissues and nerves of the eye socket.

“But, Hydroxyapatite eye-ball is expensive than Acrylic. The eye-ball installation is a must which is done in a theatre by a surgeon. I do only the eye-cap, the outer part which we call `Custom made prothesis eye cap’,” says Wickremasinghe.

Question : Your `Prosthesis Eyes’ look so natural with tiny blood vessels and a black Cornea and a Pupil. Does it make movements as a natural eye?

Wickremasinghe : Yes. This is because, though the

eye-ball and the other contents are removed, tissues and nerves of the eye would not be removed. When the brain emits signals the tissues and nerves around the eye area support the artificially made eye-cap also to make the movements. It’s so simple. Our eyes don’t move two different directions, but towards one particular way at a time.

Likewise suppose one has to remove his one eye and he has to wear an eye-cap on the removed one, his eye-cap will also make movements along with the other eye. So, there won’t be much difference in the movements of the two eyes. This method is the best method in these circumstances.

Question : What is the technique you use?

Wickremasinghe : First I take an impression (measurement) of the eye while the client lies down on bed. Then I make a dummy according to the measurements. I use Acrylic plastic (which is used for dentures) which has no adverse reaction to the human body. .... to form the Scleral covershell of the eye-cap.

Though Wickremasinghe tried to get down the equipment from India to form the method, they had refused and offered him the artificially made eyes only. So, he accepted the challenge and decided to find a technique of his own.

After two years of research, Wickremasinghe managed to develop his own method to make a `Prosthesis eye’, using Acrylic as the base and `special paints’ to form the eye to look Sri Lankan. Wickremasinghe says he can call himself as the only `Ocularist’ (a person who make `Prosthesis Eyes’) in Sri Lanka.

“Dr. M. Wijetunga of Negombo Hospital is the only Oculo Plastic Surgeon in Sri Lanka. The encouragement I have been getting from him is immense. He has sent me many patients, and I have been able to fulfil their need with the maximum effort,” he says.