Eye Care
Many children born with microphthalmia or anophthalmia work with an ocularist from infancy through adolescence. Care often begins with conformers to encourage healthy eye socket growth and may later progress to a prosthetic eye or scleral shell. Because every child's anatomy and needs are different, treatment plans are individualized and evolve as the child grows. With ongoing support from eye specialists and ocularists, many children are able to achieve good cosmetic outcomes and healthy facial development.
What is the typical pathway?
1. Conformers (often in infancy)
Many babies with anophthalmia or severe microphthalmia begin with conformers shortly after birth. Conformers are clear plastic devices that help the eye socket grow and develop. Because babies grow rapidly, larger conformers are fitted regularly during the first few years of life.
2. Prosthetic eye or scleral shell
Once the eye socket reaches an appropriate size, many children transition to a prosthetic eye. Children with microphthalmia who have a small existing eye may instead wear a scleral shell, which fits over the eye. The exact timing varies by child, but many receive their first prosthetic eye between ages 1 and 2.
3. Ongoing care throughout childhood
As children grow, prostheses and shells often need adjustments or replacement. Younger children may see their ocularist several times a year to monitor socket growth and ensure a proper fit.
4. Teen and Adulthood
As your child gets older, they may need a new prostheses less frequently. During regular eye exams, retina photographs may not see behind the eye. Ocular ultrasounds can better understand the anatomy of a small or absent eye by showing structures that may not be visible during a routine examination. As children with microphthalmia or anophthalmia grow into adulthood, ongoing support may include ocularist care, ophthalmology follow-up, low vision services, reconstructive options, genetic counseling, and peer support.
Caring for a prosthetic eye or scleral shell
Care routines vary by child and device, so families should always follow their ocularist's instructions.
General maintenance may include:
Regular cleaning as directed by the ocularist.
Professional polishing every 6–12 months.
Monitoring for redness, discharge, discomfort, or poor fit.
Periodic replacement as the child grows.
Helpful Resources for Families
Government & Medical Resources
National Eye Institute: Eye Devices for Anophthalmia and Microphthalmia
National Eye Institute: Anophthalmia and Microphthalmia Overview
CDC: Anophthalmia and Microphthalmia Information for Families
Ocularist Resources
American Society of Ocularists – Find an Ocularist and Patient Resources
American Society of Ocularists – When You Should See an Ocularist
Family Support
Understanding Prosthetic Eyes and Shells
Cleveland Clinic: What Is an Ocularist?
Cleveland Clinic: Prosthetic Eye Overview