A missing eye presents a distinct visual appearance, varying based on whether the eye socket is empty or fitted with a prosthetic device. This appearance is influenced by the characteristics of the eye socket, the effect of an artificial eye, and the condition of surrounding tissues and the circumstances leading to the eye’s absence.
The Appearance of an Empty Eye Socket
When an eye is absent, the orbital cavity appears as a deep, hollow space. This space is lined with pinkish conjunctiva. Initially, some bruising and swelling may be present around the socket, gradually subsiding as healing progresses.
After healing, the eye socket presents as a concavity lined by healthy, pink conjunctiva. The eyelids, eyelashes, and eyebrows remain, but without the eyeball’s support, they may sink inward or alter contour. This creates noticeable asymmetry compared to the unaffected side of the face.
How a Prosthetic Eye Changes the Look
A prosthetic eye, also known as an ocular prosthesis, is a medical device designed to replicate the appearance of a natural eye. These prostheses are typically crafted from acrylic. An ocularist, a specialist in creating these devices, custom-makes each prosthetic to match the color, iris, and pupil of the remaining natural eye.
The prosthetic eye is a shell that fits over an orbital implant, surgically placed within the eye socket. This implant helps maintain socket volume and allows the eyelids to regain a more natural curvature, reducing the sunken appearance. While a prosthetic eye can achieve some movement with the orbital implant and remaining eye muscles, its motion is often not as extensive or fluid as a natural eye. The pupil of a prosthetic eye does not react to light, creating a subtle visual difference compared to the healthy eye.
Factors Influencing the Overall Appearance
Several elements contribute to the overall visual presentation of someone with a missing eye. The condition of surrounding tissues, including the eyelids, orbital fatty padding, and underlying bone structure, plays a significant role. Over time, fatty cushions within the eye socket can atrophy, leading to a hollowed appearance even with an orbital implant. Scarring from injury or surgery can also modify the aesthetic.
How an eye becomes absent also influences its visual outcome. In cases of “phthisis bulbi,” the eye shrinks and becomes non-functional, often appearing smaller, discolored, and sunken.
Surgical removal procedures, such as enucleation or evisceration, have distinct visual implications. Enucleation involves the complete removal of the eyeball, typically followed by an orbital implant to restore volume. Evisceration removes only the internal contents of the eye, preserving the outer white layer and eye muscles, with an implant placed inside. While both procedures aim for a similar external appearance with a prosthetic, evisceration may allow for more natural prosthetic movement due to preserved muscle connections.