THROUGH meticulous work, a small team of specialists have become the nation’s experts in recreating patients’ eyes.
There are three highly skilled ocularistry technicians responsible for the casting and hand-painting of artificial eyes at Moorfield’s Eye Hospital, making it the largest dedicated hospital department in the UK.
There are no official courses in ocularistry, so training is by apprenticeship and attracts people from a variety of disciplines.
Senior ocularist Peter Coggin studied illustration at art school before joining the department, while his two colleagues come from a background in dental prosthetics.
Mr Coggin said: “If a patient has had a recent enucleation, where the eye has been surgically removed, they come to us and we normally fit a temporary shell to start with, as there is usually a bit of internal swelling.”
The best match for both colour and shape is chosen from thousands of stock shells, which the patient can wear until their custom eye is finished.
“They don’t go away with a perfect match,” Mr Coggin said, “but no one else would know.”
The patient returns in a couple of months’ time when the swelling has reduced, so that an impression of the socket can be taken. This is done by inserting an impression material with a “custard-like consistency” which then sets to a hard rubbery shape. From this form the shape is cast in plaster and then wax, to form a model which the patient can try out.
While the castings take place, the ocularist hand-paints the iris colour with the patient present.
Mr Coggin said: “It’s always best to have them sitting there so we can keep checking as we go along and build up the colour until we’ve got the right depth.”
The results are more realistic than painting from a photograph.
The ocularist then paints on a black disk and adds veins and staining to make the sclera, or white of the eye, more realistic. A transparent unit sits over the painted area to give the impression of a domed cornea.
The eye is then made in acrylic. It is still possible to have artificial eyes made in glass if the patient is allergic to acrylic but acrylic is far more durable and comfortable to wear.
Other items made in the Ocular Prosthetics Department include spectacle-mounted or adhesive prostheses for patients without the lids to hold the eye.
The team make shells with a clear centre for patients that have a discoloured iris, but retain some level of light or movement perception.
Chief ocularist Nigel Sapp has seen major changes in the profession during his career.
He said: “The eyes used to be all fitted from stock when I started.”