An eye that is blind and painful, or that looks different from the other eye, affects comfort and confidence, and so does losing an eye after an injury or an operation. An artificial eye (ocular prosthesis) cannot bring back sight, but surgery and a custom prosthesis can give you a comfortable socket and a natural appearance.
This page explains the options, fitting, care and socket problems for anyone who has lost an eye or may need an artificial eye. If an eye must be removed because of cancer, see enucleation and the artificial eye.
What is an artificial eye?
Most artificial eyes today are not balls but thin, curved shells of acrylic, a medical plastic. The prosthesis sits behind the eyelids, in front of the eye or of the implant that replaces it. An ocularist, a specialist in fitting, painting and making custom prostheses, shapes it to your socket and hand-paints it to match your other eye.
An artificial eye gives no vision. It restores appearance, supports the eyelids and, in a child, helps the socket and face grow. It also differs from an orbital prosthesis, the silicone facial prosthesis used after exenteration, when cancer in the orbit requires removal of the eye with the surrounding tissue (see orbital tumors).
| Part | What it does | Who provides it |
|---|---|---|
| Orbital implant | a sphere that replaces the volume of the eye after evisceration or enucleation; the eye muscles move it | the surgeon |
| Conformer | a clear plastic shell that holds the shape of the socket until the prosthesis is ready | the surgeon |
| Prosthesis or scleral shell | the visible, painted part, removable for cleaning | the ocularist |
Who may need an artificial eye?
- A blind, painful eye, for example after end-stage glaucoma, a long-standing retinal detachment, chronic inflammation (uveitis) or complications of surgery.
- A severe injury, or a severe infection inside the eye (endophthalmitis), that leaves no chance of useful vision.
- A shrunken, non-functioning eye (phthisis bulbi), which may ache or look small and cloudy.
- An eye missing or very small from birth (anophthalmia or microphthalmia).
- Removal of an eye for a tumor.
For a painful blind eye, drops, laser treatment (cyclophotocoagulation) or an injection behind the eye often relieve the pain. Evisceration or enucleation is considered when they do not give lasting relief; it removes the source of the pain, although some people later notice phantom pain or discomfort in the socket.
Your options: a shell, evisceration or enucleation
The choice depends on whether the eye is painful, whether a tumor could be present, the size of the eye and your own wishes.
| Option | What it involves | Usually considered for | Movement of the artificial eye |
|---|---|---|---|
| Scleral shell | a thin custom prosthesis worn over the blind eye; no surgery | a blind eye that is comfortable but looks different | follows the eye beneath it |
| Evisceration with implant | the contents of the eye are removed; the white outer wall (sclera) and the eye muscles stay, with an implant inside | a blind painful eye, severe infection or injury, when no tumor is suspected | often slightly better than after enucleation |
| Enucleation with implant | the whole eyeball is removed; the eye muscles are attached to an implant | a known or possible tumor, some severe injuries, a very small eye | partial |
A cosmetic shell over a blind eye
If a blind eye does not hurt but has shrunk, turned or clouded, a scleral shell (cover shell), worn over the eye rather like a large, thick contact lens, may be enough. A well-made shell can combine comfort, fit and symmetry, but the eye must tolerate it: if it stays painful, inflamed or too sensitive, surgery with an implant can be more comfortable in the long term.
Evisceration with an orbital implant
The contents of the eye are removed, while its white outer wall (sclera) and the eye muscles stay around an implant. Compared with enucleation, the operation is shorter and simpler, disturbs the socket less, often gives better movement and can sometimes be done without general anesthesia. It is not used when a tumor is suspected and suits a very shrunken or very small eye less well.
Enucleation with an orbital implant
The whole eyeball is removed and the eye muscles are attached to an implant deep in the socket. It is chosen when a tumor is known or suspected, so that the pathologist can examine the whole eye, and also for a very small eye (microphthalmos), after some severe injuries and to prevent sympathetic ophthalmia, a rare inflammation of the healthy eye after injury to the other. Implant types are described on the enucleation page.
How is an artificial eye fitted after surgery?
The socket must heal before the prosthesis is made; the course is similar after evisceration and enucleation.
- Planning. Examination, scans and the choice of operation; decide early who will make your prosthesis.
- Surgery. A clear plastic conformer is placed behind the eyelids to preserve the pockets (fornices) that will hold the prosthesis; a pressure dressing stays on for a few days.
- The first weeks. Swelling and bruising settle over one to two weeks. Use the prescribed drops and keep the conformer in: an empty socket can start to shrink.
- About 4–8 weeks after surgery. Once the lining has healed, the ocularist takes the shape of the socket and makes a prosthesis painted to match your other eye.
- Fitting. The prosthesis is adjusted for comfort, lid position and gaze, and you learn to remove, clean and insert it.
- Follow-up. Check-ups, regular polishing and, over the years, a new prosthesis.
Custom or ready-made?
Ready-made ("stock") eyes are mass-produced in standard sizes and colors and cannot fit an individual socket or match the other eye closely. A custom prosthesis is made for your socket and your other eye, and its fit also helps keep the socket healthy, which is why it is the usual aim.
Will the artificial eye look natural and move?
A well-fitted custom prosthesis usually looks natural in everyday conversation. It moves with the implant or with the eye beneath a shell, but less than a natural eye, especially when you look far to the side. In one comparison, prostheses over implants without a peg (a post linking implant and prosthesis) kept about 50% of the other eye's movement, and 87% with a peg, but pegs caused frequent complications and are now rarely used. The artificial pupil does not react to light.
How do I care for an artificial eye?
Most people leave the prosthesis in most of the time and remove it only as often as their ocularist advises. Wash your hands, handle it over a soft surface and clean it only as your ocularist shows you, since alcohol and solvents can damage acrylic.
| Care | How often |
|---|---|
| Lubricating drops | whenever the socket feels dry or gritty |
| Professional polishing | once a year if you remove the prosthesis regularly; twice a year if you do not |
| Ocularist check-ups | children under 3: every 3 months; children under 9: twice a year; everyone else: at least once a year |
| New prosthesis | adults every 3–5 years; children every 2–3 years, as they grow |
See your ocularist sooner if the eye looks in a different direction, is scratched or coated, causes more discharge, looks sunken or makes the upper lid droop, or if a prosthesis over 5 years old starts to slip or feel uncomfortable. Impact-resistant glasses are widely recommended to protect your remaining eye, and adjusting to one eye and a new appearance takes time; support from family and the care team matters.
Which socket problems can occur, and how are they treated?
Many problems are solved by the ocularist adjusting, polishing or remaking the prosthesis; others need a second operation.
| Problem | What you may notice | Treatment options |
|---|---|---|
| Discharge and irritation (dry socket) | mucus, crusting, a gritty feeling; the prosthesis becomes hard to tolerate | lubricating and anti-inflammatory drops, polishing or refitting; sometimes closing the tear drainage openings or surgery on the socket lining |
| Sunken look (post-enucleation socket syndrome) | a deep hollow above the eye, a prosthesis that seems to sit back, a drooping upper or loose lower lid | a modified prosthesis, added volume with an implant, filler or dermis-fat graft, eyelid surgery |
| Implant exposure | a spot where the implant shows through the lining, persistent discharge | prompt examination; a patch graft for small areas, a new implant or a dermis-fat graft for larger ones |
| Contracted socket | shallow pockets; the prosthesis falls out or cannot be worn | deepening the socket with grafts from the lining of the mouth, amniotic membrane or a dermis-fat graft |
A dry socket usually has several causes: an unstable tear film, incomplete blinking, rubbing of the prosthesis and oil-gland problems in the lids. In a survey, 94% of ocularists felt that a sunken eye or deep upper-lid hollow is more common after enucleation than after evisceration. A socket can contract after radiotherapy, infection or repeated surgery, or when the conformer or prosthesis is left out for long. A dermis-fat graft is deep skin and fat taken from the abdomen, flank or buttock. Lid problems are treated with eyelid surgery.
Children: helping the socket and face grow
No treatment can create a seeing eye for a child born without an eye (anophthalmia) or with a very small eye (microphthalmia), but conformers and later a prosthetic eye help the socket grow and improve appearance. Care is shared by an ophthalmologist, an orbital and oculoplastic surgeon and an ocularist.
When an eye is removed in early childhood, that side of the orbit can grow less. A well-sized implant or a dermis-fat graft, which can grow with the child, plus regular enlargement of the prosthesis supports symmetrical growth; some children need devices that gradually expand the socket. Children under 3 usually see the ocularist every 3 months. Prof. Türkoğlu treats adults and children and plans a child's care with the family and the other specialists.
What happens at your consultation?
Prof. Türkoğlu asks what happened to the eye, about previous surgery, pain and any current prosthesis, then examines both eyes, the lids and the socket; if the inside of a blind eye cannot be seen, a scan is arranged or reviewed. She explains which options are realistic and what surgery can and cannot achieve. Consultations are in Turkish or English. Bring your reports, scans and current prosthesis; from far away, you can first send the reports, scans and photographs for a preliminary opinion.
Planning from abroad
Patients who travel for eye prosthesis surgery usually stay in Antalya until the first checks show that healing is on track, then fly home with the conformer in place; ask your surgeon when flying is safe. As the first prosthesis is made about 4–8 weeks after surgery, decide in advance whether this will happen on a second trip or with an ocularist near home, who can also handle polishing and replacement later. See international patients for records, travel and length of stay.
BergemHealth
Traveling from abroad?
BergemHealth, the practice's international patient coordination partner in Antalya, can arrange airport transfers, accommodation near the clinic, interpreters (English and Russian) and appointment scheduling. All medical decisions are made by Prof. Türkoğlu.
BergemHealth is a licensed travel agency in Antalya (TÜRSAB license A-8469).
Eye prosthesis surgery in Antalya
Prof. Dr. Elif Betül Türkoğlu is a Professor of Ophthalmology working in ocular oncology and oculoplastic surgery, in private practice in Antalya after an academic career at Akdeniz University Faculty of Medicine. She began her specialist career in 2010 in the oculoplastic unit of Sakarya University Training and Research Hospital and is a member of ASOPRS and ESOPRS, the American and European oculoplastic societies. She performs evisceration and enucleation with orbital implants and socket and eyelid surgery for adults and children. More on her profile.
Frequently asked questions
Can an artificial eye restore vision?
No. An artificial eye is a painted acrylic shell with no connection to the nerves of sight. It restores a natural appearance, supports the eyelids and helps keep the socket healthy, and in children it helps the socket grow. No treatment can create a new, seeing eye.
Do I always need surgery to get an artificial eye?
No. A custom scleral shell may be worn over a comfortable blind eye without surgery. Evisceration or enucleation with an implant is usually advised for a painful eye, when a shell is not tolerated, after severe injury or infection, or when a tumor cannot be ruled out. The decision follows an examination and, if needed, a scan.
Which is better, evisceration or enucleation?
Neither is better for everyone. Evisceration keeps the white wall of the eye and its muscles, is shorter and often gives slightly better movement. Enucleation removes the whole eye and is chosen for a known or suspected tumor, a very small eye and some injuries.
How long after surgery will I get my artificial eye?
Usually about 4–8 weeks after surgery, once the socket lining has healed; until then, a clear plastic conformer keeps its shape. If you live far from Antalya, decide before surgery whether the prosthesis will be made on a second visit or by an ocularist near home.
How long does an artificial eye last?
An acrylic prosthesis usually lasts 3–5 years in adults and 2–3 years in growing children. Polishing once a year, or twice a year if you rarely remove it, keeps the surface smooth. See your ocularist earlier if it causes discharge, slips or no longer looks right.
Is discharge from the socket normal?
A little mucus now and then can occur. More discharge, crusting or irritation can come from a dry socket, deposits or a poor fit, and often improves with drops, polishing or refitting. Discharge with fever, increasing pain, spreading redness or a visible implant needs prompt examination.
My artificial eye no longer looks right. Can anything be done?
Often, yes. Over time the socket can lose volume and the lids can sink, droop or loosen, so the prosthesis looks sunken. An ocularist can modify or remake it; if that is not enough, surgery can add volume, deepen a shallow socket or correct the eyelids.
References
- American Academy of Ophthalmology. Evisceration. EyeWiki. eyewiki.org
- American Academy of Ophthalmology. Enucleation. EyeWiki. eyewiki.org
- American Academy of Ophthalmology. Blind Painful Eye. EyeWiki. eyewiki.org
- American Academy of Ophthalmology. Phthisis Bulbi. EyeWiki. eyewiki.org
- American Academy of Ophthalmology. Dry Anophthalmic Socket Syndrome. EyeWiki. eyewiki.org
- American Academy of Ophthalmology. Contracted Socket. EyeWiki. eyewiki.org
- American Academy of Ophthalmology. Dermis Fat Graft. EyeWiki. eyewiki.org
- American Academy of Ophthalmology. Exenteration. EyeWiki. eyewiki.org
- American Society of Ocularists. When You Should See an Ocularist. ocularist.org
- American Society of Ocularists. Frequently Asked Questions. ocularist.org
- National Eye Institute. Anophthalmia and Microphthalmia. Updated November 2024. nei.nih.gov