On a recent Monday in a small office in North Dallas, Randy Trawnik is delicately shaving curls of wax from half of a white elipsoid. It resembles an eyeball without an iris. Curl by curl, he is crafting someone’s re-entry into normal life.
The sign on the door out front reads Dallas Eye Prosthetics, but it might just as well say “Souls Rebuilt Here.” For if the eye is a window into the soul, losing an eye is akin to losing a little bit of one’s essence, and in addition to custom-making prosthetic eyes, Trawnik and his associates help those who have lost their soul-windows heal their spirits.
Of a morning, the waiting room is a parking lot for eye patches and desperation. Patients are silent, looking inward, perhaps contemplating what they no longer have. By the end of the day their patches will be gone and the faces they show the world will be approaching wholeness. In the process of waiting with others to have their eyes finished, they will have found a support group in those with the same malady.
The goal of the office is to treat each patient fully in one day. Randy Trawnik speaks of a well-to-do golfer who began his day in the waiting room hiding behind a newspaper, crushed after losing his eye to an errant golf ball, apparently certain that no one in the room could equal him in misfortune. Soon he discovered his error and was consoling others, filling the hole in his own psyche as he did so.
Sixty percent of the patients who come to Dallas Eye Prosthetics have lost an eye through some kind of trauma such as a gunshot, a car accident, or a mishap at work. Adult and childhood diseases cause most of the other losses. Both kinds of patients must have their prosthesis replaced several times during their lives because eyes change shape as we grow older. An infant may need a prosthetic replacement a few times a year as it grows up. Without such size updating, a child’s face may grow asymmetrically. In older adults, the eye becomes smaller, requiring the prosthetic to be downsized.
Glass eyes are a thing of the past in the United States. Prosthetic eyes are now made of acrylic. Advances in ophthalmic surgery now often allow replacements to move with their active mate, disguising their artificiality. I was in an examination room with a mother, father and daughter, who were visiting the office together for the first time. Although mom had a prosthetic for years, her daughter did not know about it until the visit. The mother was in to have her prosthetic resized.
To create a properly sized replacement, an ocularist must first take an impression of where the eye used to be, using injectible, flexible molding material.
That material is then put into a mold, which is cured and used to produce a wax facsimile of the missing ocular material, which is then inserted into the patient to check for size.
Then the “art” aspect of the “art and science” comes into play. Looking into the eye of the patient, the ocularist paints an iris to exactly match the one the patient still has. In older eyes, where veins may be visible, the ocularist may use curled strands of thread to replicate those veins.
The painted iris is then inserted into another mold, made from the modified wax facsimile. That mold will be filled with acrylic material that will be cured to make the final prosthetic device.
“There’s great satisfaction in helping people feel better,” John Trawnik says. There are only thirteen ocularists in Texas. Many states have none. Patients come to this office literally from around the world because of the renowned quality of the work, and the emotional support they receive while they’re here. Many of them have been patients for years, who visit repeatedly as their eyes change shape. Most were so comfortable with the demeanor of the staff that they let me watch the fitting process. Despite nearly two decades in the practice, John doesn’t see himself tiring of it.
Entire families accompany their injured parents and siblings to this office on their journey toward wholeness. When they leave, their vision may not have improved, but they see the world in a different light.