1) What is a certified ocularist?
To be a certified ocularist, one must be a member of the "American Society of Ocularists" (ASO), a non-profit organization founded in 1957 and based in the United States. Mr. François Gordon has been a member of the ASO since 1988 and a certified ocularist (BCO) since 1993. To become a certified professional, ocularists must follow courses offered by physicians, ophthalmologists, psychologists, paramedical professionals, as well as ocularists colleagues.
After passing the examinations and with a minimum of five years of practice under the supervision of a certified ocularist, as well as a predetermined number of credits, we are eligible to get a degree from the ASO. We then continue with the certification process through the "National Examining Board of Ocularists" (NEBO), an ASO-independent agency, regulated by a federal agency of the United States, NCHCA (National Commission for Health Certifying Agencies).
We are a small group of 225 members from 15 different countries, most of whom are from the United States and Canada, and that is why we have this type of training known as "compagnonnage" or "apprenticeship" in English.
Our certification is valid for six years, and we are required to undergo continuous training with courses, exams and credit accumulation, etc. This training ensures a high standard of professional service that undergoes constant evolution.
2) What type of maintenance does an ocular prosthesis require?
The rule is simple: Only manipulate your prosthesis if necessary. The less you handle your artificial eye, the better your eye socket tissues will be. However, as each individual is unique, there may be some exceptions.
Most patients remove their prostheses and clean them with soap and water three to five times a year. If you have any eyelash or dust in your eye socket or if smoke is irritating your eye, it is recommended to remove the prosthesis and clean it. It may even be necessary to ablute with water inside the socket.
3) How to remove and replace the prosthesis for cleaning?
It goes without saying that you need to wash your hands with soap and water and rinse them thoroughly before manipulating the prosthesis.
The following instructions are for right-handed people; hands should be reversed for left-handed people. Using the index finger of the left hand, pull the lower eyelid down to the eyelashes to remove the prosthesis.
Find the lower edge of the prosthesis with your right-hand fingers or use a suction cup on the anterior surface of the prosthesis.
Using the thumb of the left hand, lift the upper eyelid to remove pressure on the prosthesis.
Finally, remove the prosthesis by moving it forward with the fingers of the right hand. Try as much as possible not to let go of the prosthesis. Clean the prosthesis using the fingertips with warm water and soap. Rinse thoroughly and do not dry.
To replace the prosthesis: Using your left thumb, firmly hold the upper eyelashes on the eyelid, and raise the eyelid to create space. Hold the ocular prosthesis with the right hand and insert the upper portion of the prosthesis in the space created by the left hand.
When the prosthesis is in place in the upper part of the orbit, continue to hold the prosthesis with the right hand and using the left index finger, pull down the lower eyelid to the eyelash. Finally, using the right hand, push the prosthesis firmly in the orbit and release the lower eyelid.
4) What is the lifespan of an ocular prosthesis?
Although each situation must be assessed on a case-by-case basis, the lifespan of a typical ocular prosthesis varies between five and seven years, depending on the patient's environment, eye socket changes, quality of prosthetic maintenance, patient’s health, etc. This periodicity optimizes the comfort and aesthetics of the prosthesis.
5) How often should I visit my ocularist?
It is strongly recommended that you visit your ocularist at least once a year to check the condition of the "artificial eye", the eye socket tissues, as well as the fitting of the prosthesis in the socket. More importantly, the ocularist will polish the ocular prosthesis to remove any protein deposit, salt from tears, bacteria and other microorganisms naturally found in the normal socket secretions.
Thanks to polishing, you will enjoy immediate comfort and aesthetics. The visit typically lasts only 30 minutes. Visit frequency varies according to patients’ needs, and some may need to come every six months. An annual check-up is the recognized and recommended visit frequency among ophthalmic practitioners.
6) Are there any surgical solutions for patients with an ocular prosthesis to improve comfort, aesthetics, or both?
Since this is a medical issue, you should discuss it with a doctor. However, as professional ocularists, we will strive to offer ocular prostheses that improve your comfort and aesthetics without having to undergo surgery.
We can also recommend medical specialists such as ophthalmologists, also known as oculoplastic surgeons, who will correct drooping eyelids, restore the socket "cavity", and replace the existing eye socket prosthesis.
Ophthalmologists oculoplastic surgeons are scarce, and they are generally found in large urban areas such as Montreal and Quebec. They are usually affiliated with university hospitals. The costs incurred for both these consultations and surgeries are generally covered by the Régie d'Assurance Maladie du Québec (RAMQ), with a few exceptions.
Contact us regarding this matter. We will offer you a free consultation and will guide you through this process.
7) What is the waiting period for getting my new prosthesis, and how many appointments will be necessary?
You will normally be given an appointment for a new prosthesis within two weeks. In most cases, we will make the new ocular prosthesis on the same day, depending on your schedule and availability.
The manufacturing is carried out in three steps, with breaks of about one hour between each step. The day starts at 9:00 am, or 9:30 am. The first step involves taking the measurements, the orbit impression and the reproduction of the iris.
The second step is the reproduction of the "sclera" (white outer layer of the eyeball) and the modification of the iris. The third step involves fitting the ocular prosthesis, evaluating the level of comfort and aesthetics, and making the necessary adjustments and the final polishing.
Usually, the day ends between 3:00 pm and 5:00 pm, and you can walk out with your new prosthesis. We will give you the old one in a practical and strong plastic container.
8) Does my new prosthesis have a manufacture warranty?
Yes, our new prostheses are backed by a full one-year warranty, without any additional charges, even if your orbit changes naturally. However, there may be additional charges in the case of children for a child orbit undergoes several changes during this period of rapid growth and requires more frequent monitoring.
This follow-up is designed to achieve the highest level of facial symmetry in synergy with the growth of the orbital tissues. Each case will be individually discussed with the parents.
9) Are there different prices for different grades or categories of ocular prostheses?
No, we offer only one quality, guaranteed by a certified ocularist since 1993. There are, however, two types of ocular prostheses available at different prices: The convential prosthesis (enucleated or eviscerated eye) and corneal-scleral shell prosthesis that covers an atrophied, off-centred, discoloured and non-seeing eye.
The shell-type ocular prosthesis being very thin and difficult to manufacture is a bit more expensive.
Extensive experience and a high degree of expertise are required to get the desired results when manufacturing this type of prosthesis since it is intended for a still existing and, therefore, more sensitive “eye”.
Besides, it is strongly recommended to make a tailor-made "test shell", using clear plastic impressions, especially for the first ocular prosthesis that the patient will wear.
10) Is it possible to modify, adjust, repair or enlarge an ocular prosthesis?
Yes, in most cases, it is possible to modify, adjust, enlarge or repair an ocular prosthesis for four years and sometimes a little more. However, each situation must be evaluated on a case-by-case basis, and sometimes we may be unable to make these changes owing to early plastic deterioration or significant changes in the orbit.
The iris or the sclera of the natural eye rarely changes "colour." However, this may occur as a result of medication-taking or following a surgical or therapeutic intervention on the natural eye (glaucoma, diabetic retinopathy, corneal implant, cataract, etc.). If such a situation arises, we can still change the colour of the existing prosthesis, while always taking into account the general state of the "artificial eye".
Should you have any further queries, we will be happy to answer them personally.
Do not hesitate to contact us by phone or email, or make an appointment!