L
osing an eye – be it from an accident, illness or congenital condition – brings not only loss of sight in the affected eye but also emotional and social challenges that can impact one’s self-esteem and even career prospects.
However, with the aid of an artificial eye or ocular prosthesis, individuals can regain their confidence and live without social stigma, even though prosthetic or glass eyes do not restore vision.
Oculoplastic, orbital and lacrimal specialist Dr Evelyn Tai Li Min from Universiti Sains Malaysia Specialist Hospital (HPUSM) here said prosthetic eyes offer patients a second chance to face the world with confidence.
“The absence of an eyeball is not merely a cosmetic issue, but one that affects emotions and self-worth. Some patients experience depression and psychological stress after losing an eye, especially when the eye has to be removed due to disease to save their life.
“While prosthetic eyes cannot restore vision, they help patients regain confidence in their appearance, which has a profound impact on their emotions and overall well-being,” she told Bernama recently.
RESEMBLES NATURAL EYE
Dr Tai said technological advances have made it possible to produce prosthetic eyes that closely resemble the patient’s natural eye.
“With a well-fitted prosthetic eye, it’s often difficult to tell the difference from a natural one,” she said, adding that the cost of an orbital implant and prosthetic eye is about RM500 for one eye.
The hospital has its own expertise in the production of eye prostheses through Dr Nor Aidaniza Abdul Muttli from the School of Dental Sciences (PPSG). Pix credit HPUSM website.
She explained that prosthetic eyes are usually custom-made to match the colour of the iris and the size of the pupil of the original eye.
“Readymade prostheses tend to look noticeably different, which is why most patients are better suited to custom-made ones. The result is so natural that other people wouldn’t realise the patients are wearing an artificial eye,” she said, noting that the process of making a prosthetic eye is quite similar to fabricating dentures.
Dr Tai added that not all patients who lose an eye are automatically referred for prosthetic fitting.
“Patients need to be examined by an ophthalmologist to determine whether their eye socket is suitable for a prosthesis. Usually, those who lose an eye due to an accident, eye cancer, severe infections or congenital deformities are referred for artificial eye fitting,” she explained.
ORBITAL IMPLANTS
According to Dr Tai, fitting an artificial eye involves two main components – the orbital implant which fills the empty eye socket, and the eye prosthesis which functions as the outer part resembling a large contact lens.
“The orbital implant helps the artificial eye move more naturally and provides better support for the prosthesis.“Without the implant, the prosthesis may not sit properly and could make the eyelids appear uneven,” she said, adding that not all patients require an orbital implant.
Dr Evelyn Tai Li Min.
“Usually, patients who undergo eye removal surgery need an orbital implant, which can be made from either synthetic materials or the patient’s own tissue. Using the patient’s own tissue is preferable as it reduces the risk of mucosal erosion and exposure of the implant over time.”
Dr Tai said the implant is placed beneath the mucosal layer to support the socket structure, with patients needing six to eight weeks to recover after the procedure.
After recovery, patients are referred to a prosthodontic specialist for the fabrication of their prosthetic eye, she added.
FABRICATION OF PROSTHETIC EYE
HPUSM – which also serves as a teaching hospital and is part of USM’s health campus here – has its own expertise in producing artificial eyes, led by Dr Nor Aidaniza Abdul Muttlib from USM’s School of Dental Sciences.
“The fabrication process begins once the patient’s eye socket has stabilised. The prosthesis is made at our laboratory,” the prosthodontic specialist told Bernama.
Zainan Alif Zahari, 29, wears prosthetic eyes to fit the size of his eye socket.
The prosthetic eye is made from acrylic resin (polymethylmethacrylate), a lightweight, biocompatible, durable and cost-efficient material that is easy to shape.
“The process involves several clinical and laboratory stages, including taking an impression of the eye socket, creating a wax model, colour matching with the natural eye, and final finishing.
“The result is a highly accurate prosthesis that closely resembles the patient’s original eye,” she said.
Dr Nor Aidaniza said patients are taught how to insert and remove the prosthesis, which can be worn continuously, even during sleep.
“However, the prosthesis should be cleaned once a month using clean water and a mild soap with a near-neutral pH (6.5-7.5),” she added.
She also said some patients mistakenly believe that an artificial eye can restore their vision.
“So, we explain to them that its purpose is purely aesthetic and to make them look like other people so they don’t feel inferior or ashamed.”
She added that children are often the most affected as they may be teased or misunderstood by their friends and classmates who do not fully grasp their condition.
“For this reason, we recommend early treatment in infants (born without an eyeball) to ensure balanced facial growth. Without an eyeball, their facial structure development can be stunted, which may later affect the child’s psychological well-being,” she said.
She also said that for children, follow-ups every three to six months are needed to replace the prosthesis as they grow.
AWARENESS STILL LOW
Meanwhile, Dr Tai said orbital implant and prosthetic eye treatments are now available at teaching hospitals such as HPUSM and major hospitals in Malaysia, expanding access to patients nationwide.
She also observed that public awareness of eye health remains low, including among those who use contact lenses for cosmetic purposes.
Some of the facial replicas of patients using prosthetic eyes were displayed during an interview with HPUSM Oculoplastic Eye Specialists.
“Many people buy low-quality contact lenses from stalls or night markets without checking whether they are approved by the Ministry of Health. This exposes them to bacterial infections.
“In severe cases, infections can cause corneal ulcers or perforations. If untreated, the eye may become unsalvageable and must be removed, a situation we want to prevent.
“Our eyes are irreplaceable, so we must take good care of them,” she said, advising users to maintain proper lens hygiene and purchase only from legitimate sources.
CASES
HPUSM’s expertise has benefited hundreds of patients, including 33-year-old Sook Tin Sukritnard Sook Tih from Kampung Terbak in Tumpat, Kelantan, who lost his right eye in a road accident nine years ago.
“The accident broke my right thigh and severely damaged my right eye. I was in a coma and woke up unable to see well. At first, I was devastated, but over time, I accepted my condition,” said Sook Tin, a vegetable seller.
He later decided to get an artificial eye after doctors warned that his eye socket was shrinking because he had not been wearing a prosthesis.
“I just wanted my right eye to look the same as my left,” he said, adding that while his vision is no longer perfect, his resolve to stand on his own feet has never faded as he values resilience over outward appearance.
Meanwhile, 29-year-old Zainan Alif Zahari from Kampung Permatang Sungkai in Pasir Puteh here, lost his left eye at the age of seven after being accidentally stabbed in the eye with a pen.
His damaged eye had to be removed and replaced with a prosthetic one.
“I’ve been using it since then. My prosthetic eye has been changed seven times so far to adjust to the changes in my eye socket as I grew up. Now I’m changing it again as it feels loose and uncomfortable,” he said when met by Bernama.
“Technically, it should be replaced every two years, but I haven’t been able to do so because it takes time and I have to wait for my turn.”
He admitted that after he received his prosthetic eye, he initially felt self-conscious as some people stared at him strangely.
“I used to feel embarrassed to go out, but now I’m just grateful that I can still see with my remaining eye and continue working. I’m much more confident now because my artificial eye looks natural and doesn’t hurt,” said Zainan, who is self-employed.
HPUSM, which also serves as an ocular prosthetics referral centre on the east coast of Peninsular Malaysia, offers clinical services in artificial eye design and fitting, supported by a team of experts in various fields, including ophthalmology, dental moulding and psychosocial rehabilitation to improve the quality of life for patients who have lost their eyes.
