“The thing that I remember the most is the noise. It was a really, really loud noise. I had no idea I was as badly hurt as I was. I was still walking around and then all the chaos around me started because people got to me,”
“My actual eye was half hanging out of my face apparently. I didn’t know all of this, I just knew there was a lot of blood,” reflects 42-year-old Lloyd Daniels.
In an office building on Perth’s Hay Street, a peculiar industry is thriving. The art of prosthetic eye making in Western Australia is a family affair as Paul, Jenny and Emily Geelen create three to four artificial eyes each week at Perth Artificial Eye Services.
“It’s a thing; nepotism and ocularistry. My mum was making artificial eyes and she trained Paul who is my brother and me, and now we’re training Paul’s daughter Emily, who’s my niece,” explains Jenny. The Geelen family are international leaders in the industry with decades of combined experience and education, offering their services of support, manufacturing, and maintenance of prosthetic eyes to their clients.
Jenny and Paul’s mother bought the once-struggling business when the family moved to Perth from Papua New Guinea. At the time she didn’t know anything about the industry, she bought it simply because it was for sale.
“Mum used to bring the eyes home after work when I was a teenager, so when I’d finish school there would always be eyes on the kitchen table and things she was working on after dinner,” says Jenny .
“She worked on her own and had a family so she had to take the work home. She couldn’t stay around and do the laboratory work after she saw her patients. She lugged a huge suitcase home everyday and did her laboratory work at home. We don’t do that anymore. It’s all done here and also we’ve got three of us working here now, so it’s a lot easier,” Paul continued.
Jenny says, these days, they mostly see adult eye loss from cancer and children with Microphthalmia, a condition where an eye abnormality occurs before birth. Paul later explained that as work-safe practices and car safety have improved in Australia, fewer patients are referred for trauma-related incidents, and concurred he sees more of these accidents in his international clinic, based in Dubai.
When these trauma-based stories are shared in the Perth practice, the Geelens’ support is particularly crucial, and a unique aspect to their services.
Daniels’ story is a confronting one. The 2007 workplace accident occurred in seconds but altered his life forever. Working as a tyre fitter at the time, he was demonstrating an all-day, everyday task to a trainee when the tyre clamp he was fitting sprung up and hit him in the face. He described his half an hour wait for the ambulance in detail.
“I ended up choking on my blood and that was when it really got frantic around because I asked for a rag to blow and try and clear my airways, to blow my nose, and when I did the remainder of it popped and it was like a fountain coming out. My boss’s wife was standing [nearby] and she vomited,” he remembers.
He was rushed to Perth Royal Hospital, revived once on the way there, before undergoing his first two surgeries that night. “They told me they saved my eye. I had to wait two days, or three days, when they took off the bandages I couldn’t see anything so they did the light test and all I had was three specs of red so they repeated the operation, and repeated the operation, and then the decision had to be made whether to keep my eye or not,” Daniels says.
The Geelens explained that while some move quickly through the eye-loss journey, others are deeply affected.
“It’s a grieving process that people go through when they lose the eye,” Paul says.
However, he reflects “some people genuinely just breeze through it. If you’ve had a blind and painful eye for many years, sometimes removing it is a blessing.”
No matter the experience, these artificial eyes are crafted to look as real and life-like as the trio can get them, but it’s not always easy in trauma-based cases. Without that glimmer in a client’s eye, it is often a matter of waiting for the patient to recover from this psychological trauma.
“I find if someone is particularly traumatised and you get some people who look quite dead behind the eyes, then trying to get the eye to look life like is impossible, you can’t paint life into it, there’s just some people who are so heavily traumatised by it and have no life in their eyes,” Jenny says.
“You just do the best you can. Keep talking to people and hopefully they come good eventually and you can make them a better eye in the future. They look okay, it’s not like they look too bad, it just misses that spark,” she conceded.
In the Geelens’ inner-city clinic, talking is regarded as a crucial aspect to overcoming such trauma. Daniels says he felt as though he could ask the Geelens anything, at any time, and that he would contact them before his eye surgeons if he had any questions.
“They come across to me as not specialists, but friends. That’s how welcoming they make you feel and that’s what you want to feel,” he explains.
In the days, weeks and months following his accident, Daniels felt he needed to see a psychologist to get a more solid grip on his experiences. His advice for others going through something similar is to talk.
“The biggest thing I say is people must talk about it because if you bottle it up inside it all starts to get too much and that’s when you start feeling different and all of that and I’m no different to any of these people,” he says.
Paul explained losing an eye and receiving an artificial one in its place naturally comes with a period of adjustment. While the new eye should not hurt in the socket, and clients need to remove it only every one to three months, it’s more often the mental adjustment that can take some time.
“To wear an artificial eye there is an adjustment process that you need to go through. Part of that is the adjustment to the comfort level of wearing the artificial eye but part of it is also psychologically taking that in as your self image, so when you look in the mirror you expect to see an image of yourself looking back. When you lose an eye, the first time you look in the mirror you see yourself with an artificial eye but after a few times, I imagine, you just see yourself,” Paul details.
Chloe Joachim, now aged 25, was diagnosed with acute myeloid leukaemia at just 12 years old. Following complications with chemotherapy, she lost sight in her right eye, and met Paul and Jenny almost immediately after.
“I don’t think it really affected me too much because I was so young and it was quite easy to adapt to things and probably because I was so sick. At the start it was more kind of adjusting to depth perception and that sort of thing. Quite a few times I’d bend down and crack my head on bench tops or whatever,” she says.
Joachim wears what is known as a ‘haptic lens,’ an eye prosthesis that sits over the top of a dead or damaged eye. This means that despite the eye not functioning, she did not need to get it removed. This type of prosthesis is just one of the few models created by the Geelens.
The process of creating artificial eyes can begin before surgery if it’s a planned event, or soon after if not. The Geelens explain the process and answer any questions their client may have before beginning the physical work. A patient’s surgical pressure bandages are generally removed four days post-operation and it is at this point the Geelens see clients more regularly to craft a new eye.
“For taking the shape, we take an impression of the socket to get all the contours in the back there and we use the same impression paste that dentists use, so it’s spearmint-flavoured and green. Once we have the shape, we then make it up into plastic. On the second visit, we try that shape in, do some adjustments, put an iris in, get the alignment right. On the third appointment, we hand paint everything and on the fourth appointment we try it in,” trainee Emily Geelen explains.
“Ninety-nine percent of the time there’s an adjustment. The fifth appointment is the final fit. Then usually after that we have checks maybe after two weeks to a months just to see how everything’s gone,” she continues.
Jenny remarked that crafting artificial eyes makes her feel like Santa Clause everyday.
Paul continues, “you get a lot of job satisfaction really. You’re helping people, you’re actually creating and it’s very hands on so it’s very creative work. You drink a lot of coffee with patients, get to hear some wonderful stories and get to know people very well. We’re really making a real difference in people’s lives and that’s very good for the soul.”
With no offical training course in place, Paul and Jenny became founding members of Ocularists Association of Australia in 2001 to ensure the industry is self-governed and ever evolving. This organisation has fifteen members who meet twice a year, with the Geelens presenting and attending at European conferences as well.
To become an ocularist Paul says you need to know someone in the industry to get started and then undergo around five years of intensive training, which he feels explains the family dynasties worldwide.
Despite a new eye needed every five to ten years for adults, and more often for children, Paul explained there is not a lot of research and development within the industry. According to Paul around one in 2000 people require an artificial eye but most wear the current model comfortably. However, further developments are being made internationally with some he would like to see in Australia.
“It still takes a long time to make an eye; we put about ten hours into it so if there’s things that can be done to improve that like 3D printing then it may be beneficial to do it,” he says.
Daniels says that in spite of the accident, he was determined to return to sport, work and driving as soon as he could. When the surgeons told Daniels he would not get back to professional competitive cricket, he wanted to prove them wrong and did just that, with the Geelens’ support and experience assisting him with how to navigate living with monocular vision.
“I’m very determined. Don’t tell me I can’t do something,” he warns.
Joachim is now studying nursing. She says her advice to anyone needing an artificial eye is that they should not be scared because as she has discovered, it’s a positive thing.
“It’s sort of just given me confidence, made me feel normal again,” she continued.
Both Daniels and Joachim reflected on their time with the Geelens and the connections made based on support and community and acknowledged the significance of having some of the world’s best professionals at home here in Perth.