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| title | chunk | source | category | tags | date_saved | instance |
|---|---|---|---|---|---|---|
| Ocular prosthesis | 1/6 | https://en.wikipedia.org/wiki/Ocular_prosthesis | reference | science, encyclopedia | 2026-05-05T07:31:20.544903+00:00 | kb-cron |
An ocular prosthesis, artificial eye or glass eye is a type of craniofacial prosthesis that replaces an absent natural eye following an enucleation, evisceration, or orbital exenteration. Someone with an ocular prosthesis is altogether blind on the affected side and has monocular (one sided) vision. The prosthesis fits over an orbital implant and under the eyelids. The ocular prosthesis roughly takes the shape of a convex shell and is made of medical grade acrylic plastic. A few ocular prostheses today are made of cryolite glass. A variant of the ocular prosthesis is a very thin hard shell known as a scleral shell which can be worn over a damaged or eviscerated eye. Makers of ocular prosthetics are known as ocularists. Ocularists are surprisingly rare: as of 2025, there were fewer than 200 certified practitioners in the United States, and only around three dozen in India. Visual prosthesis are currently in research which could provide vision to the artificial eye.
== History ==
The earliest known evidence of the use of ocular prosthesis is that of a woman found in Shahr-I Sokhta, Iran dating back to 2900–2800 BC. It has a hemispherical form and a diameter of just over 2.5 cm (1 inch). It consists of very light material, probably bitumen paste. The surface of the artificial eye is covered with a thin layer of gold, engraved with a central circle (representing the iris) and gold lines patterned like sun rays. On both sides of the eye are drilled tiny holes, through which a golden thread could hold the eyeball in place. Since microscopic research has shown that the eye socket showed clear imprints of the golden thread, the eyeball must have been worn during her lifetime. In addition to this, an early Hebrew text references a woman who wore an artificial eye made of gold. Roman and Egyptian priests are known to have produced artificial eyes as early as the fifth century BC constructed from painted clay attached to cloth and worn outside the socket. The first in-socket artificial eyes were made of gold with colored enamel, later evolving into the use of glass by the Venetians in the later part of the sixteenth century. These were crude, uncomfortable, and fragile and the production methodology remained known only to Venetians until the end of the 18th century, when Paris took over as the center for artificial eye-making. But the center shifted again, this time to Germany because of their superior glass blowing techniques. Shortly following the introduction of the art of glass eye-making to the United States, German goods became unavailable because of World War II. As a result, the US instead made artificial eyes from the plastic polymethyl methacrylate (PMMA), commonly known as acrylic. Production of modern ocular prosthetics has expanded from simply using glass into many different types of materials. In the United States, most custom ocular prostheses are fabricated from acrylic. In some countries, Germany especially, prostheses are still most commonly made from glass.
=== Limits of realism === Ocularist surgeons have always worked together to make artificial eyes look more realistic. For decades, all efforts and investments to improve the appearance of artificial eyes have been dampened by the immobility of the pupil. One solution to this problem has been demonstrated recently in a device based on an LCD which simulates the pupil size as a function of the ambient light.
== Implant types and chemical construction == There are many different types of implants, classification ranging from shape (spherical vs egg (oval) shaped), stock vs custom, porous vs nonporous, specific chemical make-up, and the presence of a peg or motility post. The most basic simplification can be to divide implant types into two main groups: non-integrated (non-porous) and integrated (porous).
=== Nonintegrated implants === Though there is evidence that ocular implants have been around for thousands of years, modern nonintegrated spherical intraconal implants came into existence around 1976 . Nonintegrated implants contain no unique apparatus for attachments to the extraocular muscles and do not allow in-growth of organic tissue into their inorganic substance. Such implants have no direct attachment to the ocular prosthesis. Usually, these implants are covered with a material that permits fixation of the extraocular recti muscles, such as donor sclera or polyester gauze which improves implant motility, but does not allow for direct mechanical coupling between the implant and the artificial eye. Non-integrated implants include acrylic, glass, and silicone spheres.
==== Polymethyl methacrylate (PMMA) (acrylic) ==== Polymethyl methacrylate (PMMA), commonly known as acrylic, is a transparent thermoplastic available for use as ocular prosthesis, replacement intraocular lenses when the original lens has been removed in the treatment of cataracts and has historically been used as hard contact lenses. PMMA has a good degree of compatibility with human tissue, much more so than glass. Although various materials have been used to make nonintegrated implants in the past, polymethyl methacrylate is one of the implants of choice.