NSW ocularists’ retirement threatens access to artificial eye services
Ocularists provide a niche but essential service to those in need of an artificial eye, but with some considering their retirement, the field is in need of a new generation.
For the artisan prosthetists known as ocularists, an artificial eye is as much a piece of dignity as it is a medical device.
“A lot of people will literally go through life and not disclose that they wear an artificial eye, and the eye can be that good that they don’t have to,” ocularist Kerri Wilson says. “You won’t know that you’ve met those people, but you have.”
From her small studio in Sydney’s inner-western suburb of Lilyfield, Ms Wilson serves a clientele recovering from congenital defects, infections and accidents that have left them without an eye. Across a 30-year career, her affinity with her patients has become almost as crucial as her art and medicine.
Her Lilyfield studio runs on materials usually reserved for the work of dental prosthetists and jewellers. Taking pride of place is a custom-crafted lathe that lets her paint the perfect circles of an iris – its wood panel frame gives the impression of a classic jukebox. Plaster moulds scattered through the room are embedded with eyes in various stages of completion, while button irises awaiting a sclera are tucked away in a separate drawer.
Across a 30-year career, her affinity with patients who have lost an eye has become almost as crucial as her art and medicine.
“Some people will reveal just how low they feel in their life because of it. Then when they receive the prosthesis – and they look in that mirror for the first time – they cry because they’re so overwhelmed with how much they feel like their old self,” she told The Australian.
“We want to fool most people most of the time in our job, and let people get on with their lives.”
The ocularist community is one of the most niche in the medical sphere, and the Ocularists Association of Australia boasts an estimated 15 members.
That small membership is usually enough, but with the only two ocularists in NSW both pondering their retirements, and with no clear successors, that could change.
Ms Wilson is not considering leaving the field imminently but believes it will take years to pass on her experience to a new ocularist before she can hand on her business. She is reluctant to leave her patients stranded without access to the essential service.
“It would be part of my succession plan. I would be selling my business to somebody I would be training,” she said. “Because we are such a small niche industry, we don’t just train up people to be an ocularist.
“I’m such a control freak with my own work that I have managed to go this far without having a lab assistant.
“It can be a very stressful job at times. You’re making something for somebody, and it’s got to be good enough. So you put yourself under a lot of stress. It’s not a job for everybody, and they have to be competent in every angle of it; they have to be good with people, they have to have an artistic bent … and you have to feel passionate about this job. You don’t just do it for money.”
The field’s obscurity comes with downsides. A Victorian ocularist was recently barred from operating ahead of an investigation by the state’s Health Complaints Commissioner following reports of poor workmanship.
Ms Wilson said it showed regulation was increasingly necessary, despite the standards the Ocularists Association of Australia holds itself to.
“It’s upsetting having somebody out there who’s featured in the news because it’s giving our industry a bit of a bad name,” she said. “There needs to be more of an Australia-wide government standard, rather than us as an association providing that standard. It could protect the consumer, protect the community, because they don’t always know that they’re not getting a great product.”
Prosthetic eyes remain too precise to be mass-produced or 3D-printed satisfactorily, keeping the field reliant on sole practitioners.
“Each eye maker’s process is a little bit different,” Ms Wilson said. “There’s tricks of the trade, if you like, little manoeuvres that you can do with the shape of the acrylic or where the colour sits in the eye.
“It’s not just a piecework type of job. It’s really bespoke creativity.
“If you took three ocularists, got them to all make an eye for somebody and put the eye in, it would look fabulous from the three of us. But if you put the eyes next to each other on a table, they’d all look a bit different.”
Ocularist James Morphett is the only other NSW practitioner – he called Ms Wilson “the kid” when she was starting out. “Until he couldn’t get away with it,” she said.
Between the two of them, they neatly cover the state’s clientele. Mr Morphett works with most of the children in need, while Ms Wilson handles more adults. The trouble comes when both of them are eyeing retirement at once.
“I’ve been doing this for quite a while,” Mr Morphett said. “I thought I had somebody (to take over) and then that didn’t turn out okay, so I’m looking at that aspect of it at the moment.
“I’m not walking out until I’ve got somebody who’s better than me trained up, unless an actual health issue arises.
“The other ocularists in the other states trained their kids …. Whereas my kids said no. They didn’t want to work as hard as I work.
“If somebody had a background in optics, you’d need a couple of years to teach them the laboratory side of it, and if someone had been a dental technician or a dental prosthetist, you’d need a couple of years to teach them the clinical side.”
The only formal education available is a four-year course in the US, with the majority of practitioners learning through informal mentorships.
Meeting children – often at their most vulnerable – gave Mr Morphett a unique responsibility to his patients, often blooming into a lifelong connection.
“I generally like to see my kid patients every three to four months as they’re growing over the years,” he said. “I’ve had kids that I saw just after they were born. You get invited to their wedding and then they’re coming in with their own kids.”
Despite her talk of a “succession plan”, Ms Wilson acknowledges it would take a lot to occupy her attention in retirement and replace the joy that has come with a lifelong profession.
“I had a small toolbox of tricks by the time I’d been doing it for 10 years,” she said. “I’ve been doing it for 30 years now, and I look at how I was 10 years in and I go ‘oh my goodness’.
“It is one of the really enjoyable things in this job, the learning curve doesn’t stop.”
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