The Prosthetic Eyeball Is a Work of Art

Making a realistic eye takes more than technical skill: an Object Lesson.

Victor Ruiz Garcia / Reuters

The eye is about the size of a quarter, resting gently in Kurt Jahrling’s hand as he adds faint washes of yellow and blue to the white surface. The ocularist has already laid tiny, reddish-pink threads of silk over the surface to mimic the curves of blood vessels, tiny rivers winding from either corner toward the iris. A hazel centerpiece surrounds a black dot meant to mimic the pupil; as the finishing touch, he adds the arcus, a grey ring that hugs the outer edge of some aging irises.

The result is an astoundingly close approximation of the missing right eye of a 63-year-old Bostonian named Kevin. Kevin had his eye surgically removed eight months prior. Today, he’ll wear this tiny piece of acrylic home: an illusion, a practical placeholder, and a little piece of art.

When made by a skilled ocularist, a prosthetic eye becomes a part of its wearer. “I don’t think of it as alien, absurd, weird, or anything,” says Selina Mills, the author of Life Unseen, a book about the history of blindness and her own experience with it. “It’s just a part of me. I think people would like to make it all mystical and mythical but actually it’s not at all.” Mills’s eye, made by the British ocularist Paula Gladden, is so good that an emergency-room doctor once didn’t realize it was false and couldn’t figure out why it wasn’t responding to light. She doesn’t even notice it when it’s in, almost like wearing a contact lens.

Partially because they’re made to blend in, prosthetic eyes aren’t something that the average person knows much about. Many would be surprised to learn, for example, that false eyes are not spheres and they’re not glass, and haven’t been for quite some time.

The earliest known artificial eye dates back to about 2900 B.C., a gold-adorned half-sphere found in the skull of a priestess whose remains were excavated along the Iranian-Afghan border. Other ancient, false eyes were made of clay or precious metals, fastened over the eye socket with cloth or ribbon. Glass eyes came around in late 16th-century Venice. But the craft as we know it didn’t really begin to take shape until the 1800s, prompted by advancements in both surgical techniques for eye removal and techniques for the manipulation of glass.

The French were the first to become known for their glass eyes during this period, but the Germans soon cornered the market with a superior type of glass called cryolite. Because the mineral was found near the Lauscha village in Germany, that region would eventually become the epicenter of hand-blown glass eyes. Throughout the 19th century, German makers shipped a variety of pre-made glass eyes around the world to be matched as closely as possible with those in need. They were pricey, so patients receiving false eyes at the time were usually wealthy. (Although during the American Civil War, necessity led to some impressive battlefield advances for wounded soldiers, including the use of charred bone for eye implants.)

As is often the case with prosthetics, war would facilitate the next major advance after glass—plastic. World War II caused Allied countries to lose access to German glasswork, just as combat injuries increased the demand for an alternative. Multiple technicians were working on solutions through the early 1940s, but a team working with the U.S. Army Dental Corps is largely credited with some of the first eyes to be made with acrylic, a material new to dentistry at the time.

It was this invention that birthed the modern practice of ocularistry, a strange hodgepodge of professions that doesn’t quite fit into any one category. Making a good false eye requires both skill and craft, and ocularistry has retained an artisanship, like shoemaking or blacksmithing, that most skilled crafts forfeited long ago with industrialization. The field is also tiny and insular—in the earlier days, some ocularists even refused to work on them in front of patients, to protect their secrets.

Today the field is still tightly knit, but much more collaborative, with aspiring professionals completing five-year apprenticeships to receive certification through groups like the American Society of Ocularists (ASO) in the United States. The ASO counts around 170 ocularists as members, many of whom are part of family businesses. Each major city tends to have one family that makes false eyes, handing down techniques from one generation to the next.

In Massachusetts, that family is the Jahrlings. Working from a nondescript building in downtown Boston, they run the only full-time ocular-prosthetics practice in the state. The firm was founded by Raymond Jahrling, a retired legend in the field; his children, Joyce, Kurt, and Eric have since taken over, and Kurt’s 26-year-old daughter Kori is apprenticing to kick off the third generation.

Like all family practices, the Jahrlings have certain techniques they prefer, but all acrylic eyes across the industry are created in a similar way. The process usually begins with surgery to remove all or most of the non-functioning or damaged eye. Surgeons fill the open socket with a round implant, sealing it inside a layer of existing tissue called the conjunctiva. Modern implants are made of porous coral or a similar synthetic material that can easily bond with the surrounding tissue. The eye muscles are then attached to the conjunctiva so that the prosthetic eye moves in sync with the functioning one.

The Jahrlings’ role starts when a patient like Kevin walks into their office after healing from this surgery. On Kevin’s first visit, the Jahrlings took an impression of the inside of his socket using a foamy goo that sets in place. The impression was then used to make a wax dummy, which was shaved down to fit comfortably between the implant and his eyelid.

Next, and trickiest, was the creation of the iris—an incredibly detailed feature, as unique to each person as a fingerprint. The iris is made up of thousands of wavy muscle fibers, with larger openings called crypts forming floral-like patterns. Heavy pigment keeps out unwanted light, and despite the variation in human eye color, the iris contains only two types of pigments: black/brown and red/yellow. Blues and greens are a trick of light called the Tyndall Effect, in which a lower concentration of melanin in the iris causes rays of light to scatter, instead of being absorbed. Shorter wavelengths of blue and green light scatter more easily, giving the effect of a green or blue appearance. This is called structural color, as opposed to color resulting from pigment, and it’s why some blue and green eyes seem to change depending on the light in a room.

All of this to say: It takes a lot of skill to recreate a realistic iris, which oculuarists typically make with a disc and acrylic paint. Kevin’s iris was done by Kori Jahrling, who replicated the color and texture of his functioning iris using an array of tiny brushes and a surgical blade. The completed iris was then covered with a clear cornea, embedded in a mold with white acrylic, and cured with heat. Kurt applied the effects to the sclera, the white of the eye, and then coated it all with more acrylic. The result was a smooth and glossy shell, almost like a piece of jewelry.

Though different practitioners have different feelings about whether their trade can be considered art, the level of personalized detail keeps the field from being categorized as something purely scientific or technical. That doesn’t seem likely to change anytime soon: Though technological advances have arisen since the 1940s, the field of ocularistry has seen only minimal change. Every so often, for example, someone will make progress on a way to create dilating pupils, but none of these developments have made their way into common use (currently, some people swap in a second eye with a larger pupil at night). Most practitioners find it hard to imagine that the process will ever be totally automated—even as digital imaging has advanced, there’s a nuance in each individual eye that still necessitates human touch. “Eyes are special,” Kurt Jahrling says.

They’re also vulnerable. Birth defect, glaucoma, diabetes, and cancer are common causes of eye loss, but so are accidents. Joyce Jahrling recounts the split-second slip-ups that have sent people to their office—a dart, car door, hockey puck, hockey stick, paintball, a tomato stake in a garden. “Any pointed edge, really,” she says.

For each eye lost, the Jahrlings spend hours upon hours with their patients. After years in the business, Kurt Jahrling still feels the pressure when it’s time to unveil the finished product—results do vary, especially depending on condition of the surrounding tissue.

A couple hours after his eye is done curing, Kevin walks back in to the office. He’s a stoic New Englander, with a big smile and a gravelly voice, wearing a U.S. Army hat and an eye patch. He sits down in something like a dentist’s chair. Kurt Jahrling cleans the finished eye and gently positions it in the socket. Kevin closes his eyes tight a couple times, and when he opens them back up, the prosthesis has seemingly disappeared. Except for a little less mobility, which is common, it looks and acts exactly like his real eye did. Kevin holds up a mirror to examine. He makes a few facial expressions, then quietly delivers the verdict: “It’s no different.”

There’s some light joking and instructions. It’s freezing outside, so Kurt warns that the eye might get cold. Kevin gets up, puts on his coat, and reaches into his pocket for the patch before realizing he doesn’t need it anymore.

This article appears courtesy of Object Lessons.