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    Ocularist videos attract eyeballs


    Enhanced movement

    Along with Richard Downes, director of Jersey Eye Centre in Jersey, United Kingdom, Dr Pacey-Lowrie developed a technique for enhancing the motility of artificial eyes.

    For typical prostheses, the surgeon tries to retain at least three muscles and attach them to a spherical polypropylene implant full of holes. Blood vessels grow through the holes and integrate it, and the implant is attached to the prosthesis.

    The two ocularists employ an additional pegging technique in which a surgeon drills a hole in the conjunctiva after the implant is integrated. The ocularist then places a peg, resembling a rivet, into a titanium sleeve in this hole. The prosthesis sits onto this peg. “So you have the muscles moving the implant, the implant moving the peg, and the peg moving the eye,” Dr Pacey-Lowrie explains.

    Watching the videos from his home in Taranaki, New Zealand, oilrig worker Dwayne Collins got to work. His own daughter, Liberty Collins was also born with microphthalmia so severe that without a prosthesis her face would have collapsed.

    “As a father I didn't know how to deal with it,” Collins says in An Eye Fit for Liberty (https://www.youtube.com/watch?v=3Hj3sFodt7E). “What do you do? You can’t fix it.”

    Working with ocularists in New Zealand and Australia proved uncomfortable for Collins. “Some of the appointments were horrendous,” he says. In one, a mold stuck in Liberty’s eye socket and had to be removed with force that left her trembling.

    “That was it for me. I wasn’t putting her through any of that again. I wanted to know how to start making prosthetic eyes myself for my daughter.”

    “Maybe we should just let the professionals deal with it,” his wife told him.

    “Look what a professional just did to our daughter,” he responded. “I can do it better and I can do it without hurting her.”

    Watching Dr Pacey-Lowrie's how-to video, Collins began experimenting at home. “I pieced together the process to do it the best I could with the things I had,” he says. “It was really frustrating. I’d get three-fourths of the way to making the perfect eye, and in the last bit of process I'd stuff up.”

    But Collins persevered until he had created an eye that he felt comfortable giving to Liberty. “That was a moment [to] walk out to the shed and have a cry with no one looking, because I’d done something for the family finally,” he says.

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