Medical Oncologist
CION Cancer Clinics
The orbital implant and artificial eye | CION Cancer Clinics
After an eye is removed for cancer, two things replace it. An orbital implant is placed deep in the socket during surgery to fill the space and carry the eye muscles. Some weeks later, a thin acrylic artificial eye is moulded, hand-painted to match your other eye and fitted behind the eyelids. This page explains each part, the fitting, the care and what it cannot promise. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What replaces the eye after it is removed?
- What kinds of orbital implant are used?
- What happens between surgery and wearing the artificial eye?
- The terms, in plain language
- What people believe about artificial eyes, and what is true
- What should you ask, and what does this page not cover?
- Common questions about the implant and artificial eye
The short answer
What replaces the eye after it is removed?
Two things replace it. A round orbital implant is placed deep in the socket during the operation to fill the space. Some weeks later a thin, hand-painted artificial eye, called an ocular prosthesis, is made to sit in front of it, behind the eyelids, matched to your other eye.
Why two parts, not one
The implant stays inside for good, under the lining of the socket. You never see it. Its job is to replace the volume of the lost eye, so the eyelids do not sink, and to carry the eye muscles so the front piece moves a little. The artificial eye is the part people see. It comes out for cleaning and is replaced as it wears or as a child grows.
It is not a glass ball
Most artificial eyes today are made of medical-grade acrylic, a hard plastic, shaped like a curved shell rather than a sphere. The iris and the small blood vessels of the white are painted by hand. Glass eyes are still made in a few places, but acrylic is usual in India because it is sturdier and can be polished and adjusted.
What it cannot do
An artificial eye does not see. It does not change pupil size in bright light, and it moves less than a real eye when you look far to one side. At normal talking distance most people do not notice. This page cannot tell you how natural your own result will look, because that depends on the socket, the eyelids and the ocularist's skill.
Inside the socket
What kinds of orbital implant are used?
The surgeon chooses the implant. It is worth knowing which one you have, because it affects movement and later care.
Solid implants
A smooth ball of silicone or a similar plastic. Simple, widely available and less costly. The muscles are attached around it or to a wrap. Movement is usually a little less than with porous implants.
Often chosen when
- Cost is a major concern
- Radiotherapy to the socket is likely
Porous implants
Made of a material full of tiny channels, such as porous polyethylene or hydroxyapatite. The body's own tissue grows into it, which holds it firmly and can give better movement. It costs more and may need a wrap of tissue to cover it.
Dermis-fat graft
Not a manufactured implant at all, but a plug of your own skin layer and fat, usually from the hip. It grows with a child and cannot be rejected. It is sometimes used where an implant has failed.
There is a second small wound where the graft was taken from.No implant
Occasionally no implant is placed, for example when infection is present. The socket then looks more sunken, and a thicker artificial eye is made to make up the difference.
Not sure whether this applies to you?
Ask an oncologistFrom theatre to fitting
What happens between surgery and wearing the artificial eye?
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The conformer goes in at surgery
A clear plastic shell is placed under the eyelids at the end of the operation. It keeps the pocket behind the eyelids open while the socket heals. If it falls out, rinse it and put it back or call the team. Do not leave it out overnight.
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Healing and the first checks
The swelling settles over some weeks. The surgeon checks that the lining has closed over the implant and that there is no infection before referring you to an ocularist, the specialist who makes artificial eyes.
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The mould
A soft paste is gently placed in the socket to take its exact shape. It takes a few minutes and feels odd but does not hurt. From this a wax or plastic model is made and tried in for fit and eyelid position.
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Painting and fitting
The iris and the white are painted while looking at your other eye, usually in daylight. At the fitting the ocularist checks how the eye sits, how the lids close over it and how it moves, and adjusts it.
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Follow-up and polishing
The artificial eye is checked and professionally polished at regular intervals. Children need new ones as the face grows. Adults usually need replacement after several years, or sooner if it becomes uncomfortable.
Words you will hear
The terms, in plain language
- Orbital implant
- The ball placed permanently deep in the socket to replace the volume of the eye.
- Ocular prosthesis
- The artificial eye itself, a painted acrylic shell worn behind the eyelids.
- Conformer
- The clear temporary shell worn after surgery until the artificial eye is ready.
- Ocularist
- The trained specialist who takes the mould, makes, paints and fits the artificial eye. Not usually the surgeon.
- Implant exposure
- When the lining over the implant wears thin and the implant shows through. It needs to be seen by the surgeon.
- Stock eye
- A ready-made artificial eye picked from a range rather than moulded to your socket. Cheaper but rarely fits or matches as well.
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Commonly believed
What people believe about artificial eyes, and what is true
"A ready-made eye from a shop will do."
A stock eye is not shaped to your socket. It can rub, trap discharge, sit at the wrong angle and make the eyelids droop. A custom eye made from a mould of your own socket fits better, looks more natural and is usually more comfortable to wear all day.
"You have to take it out and wash it every day."
Most people are advised to leave it in and clean it in place, removing it only occasionally. Taking it out too often can irritate the socket and increase discharge. Your ocularist will give you a routine to follow, and it is usually simpler than people fear.
"Once it is fitted, it lasts a lifetime."
The acrylic scratches and collects deposits, and the socket changes shape slowly over the years. Artificial eyes need regular polishing and eventual replacement. In children, the eye must be enlarged as the face grows, or the socket will not develop fully.
"Discharge from the socket means the cancer is back."
A little mucus is normal with an artificial eye, and increased discharge is most often from a scratched eye or irritation. It should still be checked, especially if it is thick, bloody or smells. Checking is how anything that matters is found early.
Being straight with you
What should you ask, and what does this page not cover?
Before surgery, ask the surgeon which implant will be used and why. Ask who will make the artificial eye, whether that person works with the hospital, and roughly when the first fitting is likely. Ask whether the implant and the artificial eye are covered under the same approval as the operation, or billed separately.
After fitting, when to go back
Go back to the surgeon if the socket becomes painful, the discharge becomes thick or bloody, the eye keeps falling out, or you can see something pink or white showing through the lining. These can mean the implant is working its way forward. They are far easier to fix early.
What this page does not cover
It does not cover the facial prosthesis used after orbital exenteration, which is a different device. It cannot tell you exactly what your artificial eye will cost, because that depends on whether it is custom-made, who makes it, and your scheme or insurance. The linked pages go into care, appearance and cost in more detail.
If the artificial eye is uncomfortable, do not stop wearing it for long periods without talking to the ocularist. The socket can shrink when it is left empty.Questions we are asked
Common questions about the implant and artificial eye
How soon after surgery can the artificial eye be fitted?
Usually once the swelling has fully settled and the surgeon is happy with healing, which is typically some weeks after the operation. If radiotherapy to the socket is needed, fitting is often delayed until the skin has recovered. Until then, the clear conformer keeps the space ready.
Will people be able to tell?
At normal talking distance, with a well-made custom eye, most people do not notice. The difference shows more when you look far to one side, in photographs with a flash, or in very bright light, because the pupil does not change size. Glasses make it harder still to see.
Can the implant be rejected?
The body does not reject it in the way it rejects an organ transplant. What can happen is that the lining over it wears thin and it begins to show, or an infection sets in. Both are uncommon and are treated by the surgeon, sometimes with a small repair operation.
Can I sleep, bathe and swim with it in?
Most people sleep with it in, unless told otherwise. Bathing is fine. When swimming, keep your eyelids closed underwater or wear goggles, because the eye can slip out and is hard to find. Ask your ocularist about your own routine.
What if my child's artificial eye stops fitting?
This is expected as a child grows. The ocularist will enlarge or replace the eye at regular checks. Keeping to those checks matters, because a well-fitting eye helps the bones around the socket grow evenly. If it keeps falling out or the eyelids look different, book an earlier visit.
Does taking it out hurt?
No. It is lifted out by pressing gently on the lower eyelid, and slides back in under the upper lid. The ocularist will show you and a family member how. It feels strange the first few times. If it is sore, it may need adjusting or the socket may need checking.
Can the artificial eye be made to move more?
Movement depends mainly on the implant, how the muscles were attached and how well the artificial eye fits. A better fit can improve it. Some older techniques fixed a peg to the implant, but these are rarely used now. Ask your surgeon what is realistic for your socket.
Is the artificial eye covered by Aarogyasri or insurance?
The implant is usually part of the operation and covered with it. The custom artificial eye is sometimes billed separately by the ocularist. Aarogyasri, CGHS, ECHS and EHS are accepted at CION, and most cashless insurers are empanelled. Call the helpline with your card details and we will check.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
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Sources
- Cancer Research UK — Surgery for eye cancer
- American Cancer Society — Surgery for Eye Cancer
- NHS — Retinoblastoma
- National Cancer Institute — Eye Cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Enucleation: Removing an Eye for CancerThe operation in which the implant is placedHow Natural Does an Artificial Eye Look?What to expect from the appearanceCaring for an Artificial EyeDaily cleaning, polishing and warning signsCost of Enucleation and Prosthesis in HyderabadIndicative ranges and what schemes cover
Talk to us
Questions about the implant or artificial eye?
Call the helpline or send us your surgery notes. A surgical oncologist will explain what was placed and what comes next. One helpline serves every CION centre.