WILL GEIER

Optical Illusion

An ocularist makes you whole again

By Steven Ross Smith

My 94-year-old mother and I are sitting in a southwest Calgary medical office and settling in to spend the day. It will be a long one but by the time we leave, my mother will have a new right eye to replace the one that, some weeks earlier, had been surgically removed.

The room looks more like an unpretentious accountant’s office than a medical facility. The blinds are closed on the big windows to filter the daylight, and mom has just enough room to navigate her red walker to a comfortable chair. Framed professional certificates adorn the wall.

Sitting across from us is Shirley Weyland, one of only two ocularists in Alberta and just 36 in Canada. She gazes at us through brown eyes framed by brown bangs. She is personable and considerate, and displays a gentle demeanour. Recognizing my mother’s sense of vulnerability, Weyland explains each step she takes.

She begins by making a wax mould, shaping it like a miniature curved saucer. There’s an iris button, a circular dot at the centre of the arc. Weyland shapes the mould with a small blade and spatula that she heats over a flame. She glances back and forth from my mother’s eye socket to the wax material, shaping it with her hands and tools. Most of the morning has passed by the time the mould is trial-fitted and finished, and Shirley sends us away while she casts what will be my mother’s new eye.

Part technician, part artist, Weyland tailor-makes eyes to fit her clients’ physiognomies and to match their remaining eye in colour and shape.

Weeks before our appointment with the ocularist, mom had to undergo an evisceration—removal of the sight tissue and white sclera, which leaves in place two-thirds of the eye volume—at Calgary’s Foothills Hospital. This was the outcome of what we’d thought would be a routine checkup with mom’s ophthalmologist, Dr. John McWhae, who runs a clinic in Canmore General Hospital.

I had noticed—but dismissed—a clouding in mom’s eye, knowing she had glaucoma and macular degeneration. It was possible to downplay these symptoms because she hadn’t complained of discomfort. “Ruth,” say her friends, “is a trooper.” It turns out she’d developed a severe infection that was destroying her cornea, the clear front window of the eye that transmits and focuses light into the deeper eye’s lenses, sensors and nerves.

Dr. McWhae ruled out a corneal transplant because my mother had already lost most of the vision in the eye, and a transplant would be a trying surgery at her age and would not improve her vision. My mother seemed calmer than I at the news.

On surgery day, as we drove from mom’s home—an assisted living facility in Banff—to Calgary, both of us were feeling uneasy. In 2017, however, removing an eye is so routine it is done as a day procedure.

The post-op information sheet indicated that a temporary conformer would be placed in the eye socket. I later learned the doctor had also inserted a ball-shaped implant, the proper size to replace the volume of the extracted eye.

When mom’s bandage was removed several days later, it revealed what looked like a pale irritated cranberry where her brown eye used to be. Mom required six weeks of healing before we headed to Weyland’s office. There we discovered a profession I’d never heard of, practised by a woman with specialized skills.

Shirley Weyland has made more than 5,000 prosthetic eyes for people from all over Alberta, from babies to senior citizens. Part technician and part artist, she tailor-makes eyes to fit her clients’ physiognomies and to match their remaining eye in colour and shape.

Weyland has been doing this job for 32 years. She fell into it in her early 20s after she met an ocularist who visited the Saskatoon optician’s office where she worked. She was intrigued by the transformative power of this specialty.

“I liked the fact that it helped people,” she says. “I’m working with just a few patients a day—the most I work with is five. I really get to know the person.”

There were not many ocularists in Canada at the time (“there still aren’t,” says Weyland) so she saw an opportunity. To learn her skill she needed to apprentice with an accredited ocularist. This required five years, 10,000 hours, of training, coursework and passing an examination administered by the National Examining Board of Ocularists (of which the Canadian Society of Ocularists is a member). She continues to hone her skills by attending conferences, courses and workshops, and must pass exams every six years to recertify. She does not, however, have a medical degree.

“Ocularists are technicians; we’re not doctors,” she clarifies. “There’s science, there’s a craft.”

“I improve quality of life, because that’s what an artificial eye does. My clients can go out, can socialize, and people don’t know.” —Shirley Weyland

Children are the most difficult to work with, she says. “For a child of 2 years old to have to sit still in my office for five to fifteen seconds several times can be very long. Usually, children are easier to work with after age 5.” Yet those early visits most often mark the beginning of a long relationship, because Shirley will see young clients again and again as they outgrow their prostheses.

“The children I saw 20 years ago are now adults—working, going to university or having children of their own,” Weyland says. “I feel like I’ve been a part of their life for so long. It’s neat.”

At times Weyland sees a new patient at the hospital with the ophthalmologist. “While the child is under anesthetic the ophthalmologist examines the child’s sighted eye and I take an impression of the eye socket for the artificial eye at the same time. I can also look at their good eye, examine the colour and size of the iris, take measurements, and then come back to my office and begin to make an artificial eye.”

By early afternoon on the day of my mom’s and my visit, Weyland has made a new plastic eye. It is essentially an opaque white cap—imagine a medium-sized marble sliced in half—with a dark iris. Weyland writes the date and mom’s initials at the top of the prosthesis with an indelible marker; digits and letters that will be out of sight when the eye is in place.

Turning back to mom, Shirley sets out a glass mixing plate, small brushes, a tray of creamer-sized paint pots containing a variety of dry pigments and liquids. Using her artist’s eye, she mixes the pigments and begins to paint the iris. Next, with slivers of red thread snipped from a roll, she “veins” the prosthesis—teasing fine strands onto the tip of her brush then onto the sclera, the white outer layer of the eyeball. The effect is realistic.

Weyland and lab assistant Katerina Moldowa then take the prosthesis into the lab for fine-tuning. About the size of a modest bedroom, the lab has grinding and polishing machines and two shiny pressure cookers, like the ones you buy at a department store. The eye is ground and shaped a bit more, polished smooth, and then cured under pressure and hot water in the cooker.

The applied science is what initially attracted Weyland. Now, she realizes, “I improve people’s quality of life by helping them look normal, because that’s what an artificial eye does. My clients can go out, can socialize, and people don’t know they’re wearing an artificial eye. That is very gratifying.”

An hour later, there is the new eye waiting on a piece of white paper towel. Weyland gently pulls back mom’s eyelid and inserts the prosthesis.

I am astonished to see that the eye moves—a function of the remaining muscle and an implanted “bump” that fits the eye.

Weyland is an artist in her spare time and hopes to do a lot more painting on canvas when she retires. “I paint landscapes. I work from photographs I’ve taken. It’s very different from painting eyes.”

The artistry she has done this day, however, has helped my mother’s quality of life. Eyes are the jewels that link us to the world and to each other. Mom’s friends and relatives just see a normal elderly face. Weyland says she loves working with seniors because “they have really good stories. I get to hear some of their life adventures. It’s edifying.”

It’s even more edifying—even miraculous—for my mom, who told me on the way home from Weyland’s office that she thought she could see better than before. Ah, the magic of the human imagination.

Steven Ross Smith is a poet, prose writer and arts journalist, with recent work in GalleriesWest and Poets & Writers.

RELATED POSTS

Holy Healthcare

Just tell them we don’t have it here.” That’s what the nurse told me in Killam Hospital, an hour east of Camrose. I’d asked what would happen if a woman came into our ER asking for the morning-after pill. The nurse wasn’t being self-righteous, but simply explaining the policy. As ...

Optical Illusion

My 94-year-old mother and I are sitting in a southwest Calgary medical office and settling in to spend the day. It will be a long one but by the time we leave, my mother will have a new right eye to replace the one that, some weeks earlier, had been ...

Healthy Incentives

If you’re like most Canadians, you probably don’t care how your doctor gets paid as long as you receive the help you need and the government picks up the tab. But Dr. John Chmelicek thinks you should care. As president of the Alberta College of Family Physicians, he believes whether ...