Through this site I try to provide relevant information and useful links to help people navigate through the maze that is the internet.

I was fortunate to come across a new site which has been put together by Dave who will share information and answer any questions you may have based on his 40+ years of monocular vision and having worn over 10 different prosthetic eyes.

Monocular Society is a site that is dedicated to individuals living with sight in only one eye or someone living with a prosthetic (artificial) eye. These conditions can result in many physical and emotional challenges. I recommend you have a look at his site which you can find here.

I would define a “primary artificial eye” as the artificial eye fitted post operatively when someone has had an eye removed.

At the recent Ocularists Association of Australia meeting the issue of item numbers for health insurance companies was debated. To keep things simple we want to define the products and services we provide with the minimum number of item numbers.

Proposed Item Numbers

1) Ocular Prosthesis                

2) Primary Ocular Prosthesis

3) Haptic/Scleral Lens          

4) Modification  / build up to eye prosthesis      

5) Review and Polish                                                       

6) Consultation                                                                   

Item 2: (the primary ocular prosthesis) was the subject of much debate.

When someone loses an eye it is a time of emotional turmoil. It is a period of adjustment and adaption. In Western Australia we encourage clients to visit us prior to having the operation so we can help people understand the journey ahead.

 We have prepared a mind map which illustrates the various aspects of eye loss such as the operation, dealing with the emotional aspects , monocular vision and support groups. By using the mind map while we explain the various aspects of eye loss.  People can take a copy of the mind map with them and use it as a reference to remind them of all the information we share on the first visit. The information is also available on this website.

 On this first visit we will also make up an eye prosthesis which is fitted at the end of the operation. This could be defined as an aesthetic conformer shell. It is fitted as part of the surgery to hold the shape of the eye socket while it heals. Also by having the prosthesis fitted at the time of the surgery the patient and their family are not confronted by the sight of an empty eye socket or transparent conformer shell which has been the practice in the past.

About one week after the operation the pressure bandage comes off and the patient gets to see the eye prosthesis in situ for the first time. We invite clients to visit us after their ophthalmologists’ appointment so we are able to make small adjustments to the shell for the purpose of alignment. We see the client again after one week for adjustments as the socket swelling subsides.

The final prosthesis is not made until eight weeks after the operation once the residual swelling subsides. Once the prosthesis if fitted there is a follow up visit after one week to see how it is settling in.

This process including the Pre-op talk, the manufacturing and supply of the aesthetic conformer, the adjustments to the aesthetic conformer, the five or so visits to custom make and fit eye prosthesis and any adjustments to the artificial eye are all included in the one item number and are covered under the one invoice as a “primary ocular prosthesis.”

Under the current health insurance system an artificial eye is covered as an ancillary benefit. It is my hope that in the future the health insurance companies will recognise that a primary eye prosthesis is an integral part of the operation and it should be covered under the hospital table as part of the operation. This is a vulnerable time for most people who go through enucleation. There is a period of time were the patient is unable to work and it is often a financially difficult period.

People do not choose to have an eye removed for cosmetic reasons. People may lose an eye as a result of trauma or disease and is only done as a last resort.

Under the hospital table it would be covered as a part of the operation and would attract a more reasonable rebate.

I would suggest that a primary prosthesis is so much more than a product and should be recognised as a complete service. If someone has an eye removed through the public health system in Australia, the cost of the artificial eye is covered by the Government as it is recognised as an integral part of the operation and recovery. It is my hope that private health insurance companies follow suit.

We’ve just come back from another interesting meeting of the Ocularist Association of Australia.

At the meeting we discussed the development of a universal item number for artificial eyes. With the current system in Australia artificial eyes are covered by most health insurance companies as an ancillary benefit. This is similar to dental and optical claims.

The issue that causes confusion and makes it hard to make a claim is the multitude of loosely defined item numbers for artificial eyes.

With Medibank private the item number for a new eye prosthesis is EP 13 and is covered under some policies but not all with their super extras policies.

HBF use the number A802 under ancillary benefits

HIF uses item number F-A0244

Many of the smaller insurance companies there is no item number at all and payments are made add hock as ex-gratia payments.

Because there are no clearly defined item numbers the insurance companies create their own policies which results with artificial eyes being bunched in with insurance sub categories such as External prostheses. The system is so confusing that the insurance front desk staff are often unable to calculate benefits and claims need to be sent in the head office to sort out the mess.  

The Ocularists Association of Australia is implementing a set of item numbers that we hope will be adopted by all the insurance companies with clear definitions for all items. We are working with the Australian Health Insurance Association (AHIA) to adopt a set of numbers that are suitable for them.

The new item numbers will not affect the rebates people are receiving at the moment but hopefully this will provide some clarity and uniformity across health insurers. With the universal item numbers, when you talk with your insurance company or wish to compare health insurers everyone will be talking about the same thing.

In the last couple of years, Jenny Geelen has visited East Timor to craft Artificial Eyes for the East Timorese People. It has been a wonderful experience for her and she has received positive feedback.

Jenny wishes to continue with her annual trips with the idea of training someone in East Timor to make the Artificial Eyes. To help with funding for these trips, which has been self-funded in the past, Jenny has started a fundraising project.

Paul Allen is a West Australian artist who hand-crafts iconic silver ingots. He has supplied Jenny with a selection of his work which she is selling to raise funds for her East Timor clinic. He has been making the ingots since 1995 and currently lives in Kalbarri, which is 600km north of Perth, Western Australia.

Visit Paul’s Website

Inquiries can be made through the comment form below or through Jenny’s Website.

Our last blog – Losteye.com – What Can I Say? was written by guest blogger Debbie Atkinson.

I feel so pleased to have come across Debbie Atkinson’s story.  As well as writing about her experiences with Losteye.com Debbie has also given permission to link to her website and her own eye loss story, Eye Will Survive.

Debbie lost sight in her eye long before she had her eye surgically removed.  Her story beautifully illustrates that loss of sight in one eye is something people can quickly adjust to.

The surgical removal of an eye creates another major set of challenges.  Debbie’s frank description of her complex feelings during this time may help  others going through a similar experience.

I was also very interested in the emotions that Debbie describes during the process of getting a new eye made. 

I’m sure others will relate to her story and get hope from her positive experience of wearing a well made prosthetic eye.

Thanks Debbie for your courage and willingness to share with others on the journey.

Artificial Eyes and Sports

When clients visit me for the first time I will generally show them the “Adjusting and Adapting to eye loss mind map.” When I talk about monocular vision and sport I will often tell the story of James Bonner who played snooker at an international level and on one occasion competed in the Australian Open championship match against a competitor who also wore an artificial eye.
With target sports like snooker and shooting it is an advantage to have monocular vision. It helps with the alignment of the shot. With bilateral vision our brain does a clever trick by turning the two images we receive into one. We are infact deceiving ourselves. With monocular vision you are actually seeing things as they are.
James tells his story a whole lot better than I do and he has contributed his story to this site. You can see his story here .

Thank you James for your story. If you have a story that you would like to share we would love to have a look and with your permission share it on this site.

This is my seventh visit to Moorfields Eye Hospital Dubai to make artificial eyes. Moorfields has an incredibly supportive environment which makes my job uncomplicated and a pleasure. Clients are welcomed to the hospital by friendly and efficient front desk staff who take them through to a comfortable waiting room where they are offered refreshments and up to date magazines.

My clients here come from a diverse range of backgrounds. In this last trip alone I have seen clients from Oman, Kuwait, Saudi Arabia, Nigeria, Sri Lanka, India, Pakistan, Egypt, Qatar and the various states of the United Arab Emirates. I regularly use the translation service which is offered to remove the barrier of language.

Moorfields Eye Hospital Dubai is situated within Dubai Healthcare City.
Dubai Healthcare City was set up as a centre of excellence in healthcare for the UAE. It has invited leading hospitals from around the world to establish branches to encourage international specialists to consult here. Moorfields Eye Hospital Dubai is the first overseas branch of Moorfields Eye Hospital London.

It is great to be part of a team of specialists who are making such a big difference to the health and well being of the people in the Middle East. For more details about the artificial eye clinic in Dubai please click here.

An interesting and not often talked about aspect of having an eye enucleated is Phantom Eye Syndrome. It has been described as a fireworks show with flashes of bright light.

 The theory is that when the optic nerve is cut the brain receives irregular impulses and interprets them as flashes of light.

The effect varies from person to person with  some people experiencing impressive performances while 50% of people do not experience it at all. 

 Most patients claimed they had visual hallucinations from right after the enucleation.

If the patients terminated having visual hallucinations – it usually stopped in the first 6 months after the eye amputation.

Once you know it is a natural side effect of having an eye removed you need not worry about it and enjoy the show. 

Phantom Eye Syndrome: Types of Visual Hallucinations and Related Phenomena

Roed Rasmussen, Marie Louise M.D.; Prause, Jan U. M.D., D.M.Sc.; Ocularist, Martin Johnson; Toft, Peter B. M.D., D.M.Sc.

Abstract

Purpose: To describe the prevalence of phantom eye syndrome in eye-amputated patients, to give a description of visual hallucinations, and to identify triggers, stoppers, and emotions related to visual hallucinations.

Methods: The hospital database was screened, using surgery codes for patients who had received ocular evisceration, enucleation, or secondary implantation of an orbital implant in the period 1993-2003. A total of 267 patients was found and invited to participate, 173 accepted. Patients who accepted participation had their records reviewed, and a structured interview about visual hallucinations and pain was performed by one trained questioner (M.L.R.R.).

Results: The prevalence of phantom eye syndrome was 51%. Elementary visual hallucinations were present in 36%, complex visual hallucinations in only 1%, and other visual hallucinations in 14%. The elementary visual hallucinations were most often white or colored light, as a continuous sharp light or as moving dots. The most frequent triggers were darkness, closing of the eyes, fatigue, and psychological stress; 54% of patients had the experience more than once a week. Ten patients were so visually disturbed that it interfered with their daily life.

Conclusions: Phantom eye syndrome is common, and the authors recommend that surgeons inform their patients about the phenomenon.

For more information click here

I’ve recently attended a conference on Ocular Trauma where Dimitri Yellachich spoke about Trauma on the Battlefield.

During the Crimean war eye injuries made up 0.6% of total injuries.  Back in those days the battles were fought at close range.  Soldiers wore a lot of protective gear.

In the Iraq war eye injuries made up 13% of total injuries.  Now the eye is only 1% of the body so you’d be tempted to think that the eye would attract 1% of the injuries. 

Modern war is fought with highly destructive weapons and the fighting is conducted from a greater distance.  Soldiers tend not to wear their protective gear, mostly because they consider it uncool. Safety glasses can be uncomfortable and condensation and dust can sometimes interfere with vision.

Dimitri showed a slide of a pair of safety glasses that had been penitrated but had greatly reduced  the trauma to the eye.

He explained to us that a study of eye injuries in the Vietnam war had shown that 40% would have been prevented or at least lessened had the soldier been wearing safety glasses.

My mother proudly displayed the slogan ” Smart weapons stupid people! ” across the back of her truck during the Iraq war. There is no indication that the smart weapons are getting any less destructive and people don’t appear to be getting any brighter.

Dimitri’s talk was enlightening and I hope his message gets through to the right people. Safety glasses may be uncool but there is a reason they are issued to soldiers.

We have recently started a section on this website for people’s artificial eye stories. The purpose of this new section  is to attract people from around the world to share their experiences of eye loss.

Our first story has been submitted by Sanjay from Dubai. Sanjay has given a lot of thought to this and has highlighted some important aspects to his experience of eye loss. While there are many aspects to Sanjays story that are interesting, the message that I found most powerful was the one below.

“I had to make a decision on the very little option I had, enucleating
of the right eye with orbital implant and cosmetic eye shell. Well it
was painful the very thought of someone amputating a part of your body
although it served no purpose, I think it is extremely difficult to
let go of any part of your body whether functional or not.”

The decision to have an eye enucleated is such a difficult one. You hear stories in the media every day about medical breakthroughs and the decision to have the eye removed is so final. Even when you know it may be the right thing to do it is still a huge decision to make.

You can read Sanjay’s story here.

Thank you Sanjay for your story. If you have a story you would like to share please send it through via the contact page below.