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Editor’s note: Empish Thomas shares her decision about using ocular lenses and her experience obtaining, wearing, and caring for them. The blog has been updated as of May 2024.
Why I Wear Prosthetic Eyes
When I interact with sighted people, it never dawns on them that I wear ocular lenses, also known as “fake” or prosthetic eyes. They look so natural that no one knows unless I tell them. When I do, they can’t believe it. Of course, that is the whole point. Whether it is arms, legs, teeth, hair, or breasts, we live in a world that socially accepts something on the body that is not real.
I have Vogt–Koyanagi–Harada (VKH) syndrome, an autoimmune disease characterized by chronic, bilateral uveitis. As a result, I am totally blind. My eyeballs have shrunk, which causes my eyelids to close all the time.
Some people wear ocular lenses for medical reasons, but my decision was cosmetic and a bit selfish. I just wanted to look and feel better. I was tired of wearing those dark sunglasses, of the headaches and facial pressure from wearing sunglasses all day, of my eyelids closing and not being able to keep them open, of people assuming I was asleep or not paying attention because my eyelids were closed, and of the whole thing!
In addition, I realized that wearing sunglasses somehow communicated to the world that I was ashamed of my eyes. The point was driven home after attending a disability presentation called Gawking, Gaping, Staring: Living in Marked Bodies at Emory University. The presentation explored how people with physical differences are treated in mainstream society. The presenter, Eli Clare, shared how we have to “cover up” our differences to be accepted. I realized that was exactly what I was doing with wearing sunglasses. That night, the shades came down – both literally and figuratively.
Getting Fitted
After talking to some friends who also wear ocular lenses, my next step was to call my insurance company to see if my plan would cover them. Ocular lenses are expensive, and I thanked God for insurance! When I learned that my insurance would cover them, I made an appointment with an ocularist for eligibility and fitting. Since I still had both eyes, I learned that I would be fitted for partial lenses that would lie over the top of my eyeballs – much like contact lenses, but thicker, larger, and customized to fit over my eyes only.
Ocular lenses are made of durable and moldable plastic – the same kind used to make dentures. I joked with my ocularist, “Oh, I can get new eyes and teeth too?” He chuckled as he placed a test set over my eyeballs. My eyes immediately began tearing up and I cried like a baby. He said that was good because it showed that my tear ducts worked.
I asked my friend who drove me to the appointment how I looked, and she said that the ocular lenses were a noticeable improvement and opened up my face. We then decided on a color, and both agreed to keep the lenses close to my natural light-brown eye color. I did not think it would be a good idea for an African-American woman to wear blue eyes, but I did consider green for a minute or two!
Learning to Wear Ocular Lenses
In a few weeks, I returned to pick them up. My ocularist explained how to put them in and keep them clean. He asked if I wanted to wear them home, but I was too nervous. I just kept them in my little baggie.
Once I got to work, I told my co-workers, “Come look at my new eyes!” I was so excited that I didn’t realize how strange that might have sounded to people! My sighted co-workers expressed how real the lenses looked and how the ocularist had done a great job. My visually impaired co-workers touched them through the baggie and said they reminded them of large contact lenses.
Over the next few weeks, I had to work on increasing my tolerance by wearing them for segments of the day until I could wear them all day. This required me to work on putting them in and taking them out. I found that task to be very difficult, and I got frustrated with it. “Oh, the things we do for beauty!”
I realized that over the years, my eyelids were not used to being open, and my eyes were not used to having a foreign object placed on top of them. It was like I had to learn how to blink all over again. I was about to give up and throw in the towel when a friend who wears ocular lenses told me to keep trying and to be patient.
So, one Friday evening, with nothing else to do, I sat on my bed, took a big breath, and tried again. I kept myself calm and allowed my fingers to feel around my eye socket. If I pushed my upper eyelid to place them in it, it was easier than pulling the lower lid down. I also thought not using my lower lids would help prevent bags and sags under my eyes. I could do it after several tries and went to bed wearing my new eyes.
Adjustments Needed
A sighted co-worker once said my eyes looked funny – as if my pupil was looking in the wrong direction or upside down. I immediately called my ocularist and made an appointment to see the problem. After all this work and effort, I couldn’t walk around with my new eyes looking strange!
We discovered that since both lenses had smooth edges all the way around, I could not tell which direction to place them in. He then put a small notch on one side of each lens so I could touch and feel which eye was which. For my left eye, the notch was on the left side, and for my right eye, the notch was on the right side. All I had to do was feel for that notch and place it in the correct direction.
Care and Maintenance
I want to share some common tips on the care and maintenance of ocular lenses. These tips are good to follow to keep your lenses in good shape and your eyes safe. If you are wearing ocular lenses or considering doing so, I hope these tips will be helpful.
Instructions
One of the first things I did when I started wearing my ocular lenses was to get clear instructions from the ocularist. He gave me verbal and written instructions on cleaning, wearing, and maintaining my lenses properly. These instructions were important to follow so that my lenses could last and keep my natural eyes safe and free from damage or complications.
Since my ocular lenses were designed to fit my eyes only, I wear them day and night, so I don’t have to remove them very often. Initially, I removed them more often while going through the adjustment process. Since my natural eyes had shrunk and my eyelids had closed for some time, it took a while for my eyes to get used to a foreign object inserted over the top of my eyeball. I would wear them during the day and then remove them at night, and wear them day and night, only removing them for proper cleaning. I was advised that the less handling of the prosthesis, the better.
Cleaning
When it comes to cleaning, I clean my ocular lenses once a week. However, it can vary with each person depending on the amount of tear, mucus, protein deposits, and debris. Taking care and cleaning your lenses will keep them looking natural and increase their longevity. First, wash your hands thoroughly. Next, remove the lenses with your fingers or a suction cup. Softly wash lenses with warm water and mild soap like baby shampoo. Do not clean the lenses with any solvents, hand sanitizer, or alcohol because these chemicals may damage the lenses and your eyes and eye socket.
Gently rub the lenses thoroughly, then rinse them clean. Next, dry with a soft towel. Cleaning your eyes is a good idea before re-inserting the lenses. You can take a washcloth and gently lift the eyelid to clean the area, including the eyelashes. Then, insert lenses into your eye sockets. My ocularist recommends using mineral oil or lubricating eyedrops to avoid dry eyes. So, I squeeze a few drops over each lens before inserting.
Even with proper cleaning, heavy surface deposits formed by tears, protein, and mucus can present a dull film over time. This dull film can irritate your eyes and can also be a sign that it is time to get your lenses polished. Ocular lenses should be polished at least once a year. During this appointment, the ocularist will polish the lenses, check them for any adjustments needed, and answer any questions about care and maintenance.
Lenses Don’t Last Forever
Although you can properly clean, maintain, and polish ocular lenses, they do not last forever. Depending on your ocularist, you will need to replace them every 3-7 years. This might be because your natural eyeball has shrunk more, causing the lens to no longer fit snuggly. The tissue in the eye socket can change, causing the lenses to become scratched or damaged. Another cause is the natural deterioration of the lenses’ plastic and pigmentation. Other factors can be your age, overall health, and lifestyle.
It is so important when wearing ocular lenses that when you notice changes, you talk with your ocularist so that they can check and make any adjustments. This will ensure proper fitting, longevity, and overall enjoyment of your lenses.
Some Final Thoughts
I have worn ocular lenses for years and don’t regret the decision. Some people might think I am vain and too concerned about my looks, but I have to say that I look and feel fabulous, and my confidence has increased! I smile, laugh more, and feel much better about myself! The cleaning, care, and maintenance can sometimes be a bit of an inconvenience, but I would not go back to dark sunglasses for anything.