Elise’s Prosthetic Eye Change

Unlike real eyes, prosthetic eyes don’t grow, and in children who grow quickly, they need to be replaced once every few years. Elise’s first prosthetic eye was done in April 2017. We observed that the prosthetic eye kept moving out of alignment. After a consultation with Dr Ganga, he advised us to get a new one fitted.

Prosthetic eyes are handmade, and the process requires roughly three working days, including the time it takes for curing and drying. We got ours done with the same ocularist at NUH, Dr Sue.

The clinic is a small enclosed space featuring some prosthetic samples. The more complicated eye prosthetics include those made of latex to mimic the flesh surrounding the eye.

This is the imprint of Elise’s eye cavity and this is what the base of the prosthetic eye has to look like in order for it to fit snugly. I didn’t take a photo, but this was done by pouring a mixture through a mould that was fitted onto her eye cavity.

This is a brief summary and I can’t fully convey the full experience as 80% of the time involved waiting – Elise playing or on the phone watching YouTube, me mindlessly checking social media. On one particular day, I packed in a huge sticker book and other activities and my shoulder nearly gave way because I carried a tote bag.

It involves a lot of fitting and adjustment to get the angle and position right. Mainly, what we want to do is to determine the specific placement of the pupil, whether it should be right smack in the centre, or a little nearer to the nose.

Time for a #momjoke – this is Elise side-eyeing her eye. Every eye is handmade and it’s not one-size-fits-all. It’s not oval shaped, but it has a little pointed tip at the top so it holds in place.

Next, Dr Sue adds details to the eye using pigments to make it more realistic. Most of the time for Asian children, their pupils are black. Westerners have more complicated eye details and there’s a technology that can print the pupil onto the base, but it’s a film and likely isn’t as lasting.

Dr Sue mostly handles Asian patients, and paints the details by hand. This won’t be Elise’s last prosthetic eye, and we will likely have to fabricate a few more eyes before she reaches adulthood.

One thing Dr Sue advised was not to remove the prosthetic eye regularly as it affects her lower eyelid and its capability to hold the eye.

This is how she looks like now with the new eye! Due to the better fit, it doesn’t move around that much anymore. It has limited functions, like it can’t follow along when she rolls her eyes, something she does pretty often nowadays, but it’ll do!

Another Milestone

Her prosthetic eye moves out of alignment easily nowadays, and when it’s misaligned, it can appear frightening to others. When that happens, I am tasked to realign it using a small suction cup. Knowing how uncomfortable it is, she drags her heels on it. If she flatly refuses, I have to clamp her down with my legs and use one hand to pry open her eyelids while squeezing in the suction cup while she cries murder.

Today, she decided to try doing it herself. With some verbal guidance, she caught the hang of it and not only took it out, but re-inserted and aligned her eye! No tantrums, no screaming. Mighty proud of herself for having achieved this milestone, she ran off to brag to her dad and granddad, while I shared this accomplishment with her doctor via email!

Finding Peace

After receiving calls about Emmett’s biting for the past two days, I was bracing myself to hear how his next victim got attacked when it turned out to be another teacher instead. “Hello Elise’s mummy, Elise’s contact lens fell out, could you come down to put it back in? We don’t know how to put it back. Please come down now.”

Elise has been using her prosthetic eye for about 2.5 years now.

She is unable to see through that eye and it is to make her appear as if she has two eyes like everyone else. It isn’t immediately noticeable, but as the prosthetic eye is merely a cover, the pupil does not move when her natural eye does. It does not need to be removed daily, but it can be taken out for cleaning. Sometimes, when she rubs on her eye too hard, it may fall out, which is what happened today.

It brought my mind back to the first time it happened when I was alone with her. One moment, she was playing around, and the other moment, she was staring at me with an empty socket. I freaked out and immediately called the prosthetic doctor while alerting my closer friends on WhatsApp “OMG ELISE’S EYE JUST DROPPED OUT WHAT DO I DO”. I was ready to bring her to the hospital so that the doctor could insert it back for her (and me). The doctor encouraged me to try it myself first, instructing me over the phone.

Back then, she was much younger and she would not stay still because she was traumatised by her experience of being held down forcibly for tests, eye dressing changes and her wound was possibly tender and healing. It was like pinning down a squealing piglet destined for slaughter. My feelings were a mish-mash of guilt, fear, shock and pity. Eventually, I slot it in without going to the hospital.

Emotionally, it was saddening for us to come to terms with the fact. Up till now, I don’t think my husband has seen her eye socket yet.

Back to today. The same situation occurred and I saw how shocked her teachers were. They managed to cover Elise’s eye and move her to the office before other children took notice. Her form teacher told me that she couldn’t bear to look. It’s completely natural for them to have that response and I don’t blame them. After all, it’s not something they encounter often and most people can’t deal with seeing something like that. If you’re curious, her eye socket has healed and it is neither bloody or has dangling veins. It appears as pink hollow flesh.

I washed it under running water before popping it back in. Over the years, both of us has gotten used to it. Elise has observed her appearance in the mirror without her prosthetic eye (I advised her not to, she insisted) and her reaction was not one of fear or disgust. It seems that she understands and is living without noticeable problems. She can run, kick a ball and balance on beams.  However, at 3 going on 4 years old, people around her are less likely to make snark remarks about appearance. We will cross that bridge when we get to it.