The market for ocular prostheses - France

1.1 Definition and presentation

An ocular prosthesis, also known as a glass eye, is a medical device used to fill the gap left by a missing, traumatized or atrophied eye. So, while the eye's functions are not replaced, the prosthesis can reproduce the valid eye almost identically. The aim is therefore primarily aesthetic.

These prostheses are made to measure by an ocularist, a healthcare professional accredited by the French Social Security. Each prosthesis is unique.

Since time immemorial, people have tried to replace a missing eye to restore a certain aesthetic appeal. In ancient Egyptian culture, eyes were already made of precious stones. It wasn't until the time of Ambroise Paré that functional prostheses appeared (gold or silver balls with painted porcelain irises). In the 18th century, French prostheses were the most sought-after (this type of prosthesis is still used today, notably for microphthalmia). In the 19th century, glassmakers in Lauscha, Germany, developed a mixture containing cryolite, enabling the manufacture of prostheses that were highly resistant to corrosion (two to three years) and had a very natural effect. This glass is still used today (for glass prostheses), although prostheses have undergone numerous innovations in recent years.

Today, there are two main types of ocular prosthesis: those made of glass and those made of synthetic resins.

Although many eye diseases are now treated and no longer require enucleation, demand remains high (accidents, glaucoma, eye cancers, etc.).

By 2021, an estimated 0.1% of the world's population will need an ocular prosthesis, i.e. 8 million people worldwide. Nevertheless, supply remains limited.

In France, demand for ocular prostheses is very high, but treatment times are long and the number of ocularists is low (48 in 2022).

1.2 The global market

The global market for ocular implants is valued at $**.* billion in ****, and is expected to grow at a CAGR of *.*% over the period ****-****, due to the higher number of eye diseases such as glaucoma and cataracts. According to the WHO (***) in ****, ** million people suffered from cataracts in ****, and *.* million people ...

1.3 The French market: market size

In France, by ****, the number of people wearing ocular prostheses is estimated at ***,***, or *.*% of the French population , according to the Social Security. [***] This figure is stable from one year to the next, with as many people entering the loop of prosthesis wearers as leaving it (***).

New prostheses :

To estimate the ...

2.1 Strong demand

Quantitative aspect of demand: assessment of potential demand

In ****, the number of new ocular prostheses is estimated at *,***. Today, however, waiting and manufacturing times are long, and supply is limited in the face of growing demand. The demand for prostheses is therefore not fully satisfied, and actual demand is therefore greater ...

2.2 Glaucoma: one of the leading factors in the demand for ocular prostheses

Glaucoma is a chronic eye disease caused by damage to the optic nerve. It is favored by an increase in the internal pressure of the eye. [***]

Number of people affected :

Glaucoma affects *% to *% of the population over the age of **, and around **% over the age of **. *.* million people are treated for ...

2.3 Another reason for wearing a prosthesis: AMD

AMD is age-related macular degeneration. Itis a chronic eye disease that affects the central area of the retina. It develops from the age of ** onwards. Smoking, age and genetic predisposition are the main risk factors. [***]

Number of people affected :

This disease affects around *% of the French population, but its frequency increases ...

2.4 Other diseases and causes of demand for ocular prostheses

Accidents:

Diseases such as glaucoma are increasingly well treated, and prevention is increasingly effective, but the number of accidents and traumas remains very high (***), sometimes necessitating the fitting of ocular prostheses.

The leading accidental cause of blindness in France is a champagne cork in the eye. [***] There are no figures available ...

3.1 Value chain

Source: ****

Before the ocular prosthesis is fitted, the ophthalmologist must validate the tolerance test. The ophthalmologist is involved throughout the process, in collaboration with the ocularist who manufactures the prosthesis. It is the ophthalmologist who issues the prescription for the ocular prosthesis to the patient, which is compulsory. Social Security covers ...

3.2 Ocularists

Ocularists can be either self-employed or employed by a laboratory: in ****, there were ** ocularists, including ** laboratories. The majority of ocularists are therefore employed by laboratories.

The ocularist's main tasks :

Take impressions and measurements of the patient's eye Identify particularities of iris color, brilliance, shape and size of the eyeball Design the ...

3.3 The manufacture of ocular prostheses

Ocular prostheses are made from PMMA (***), a biocompatible, lightweight and resistant material. They are made up of several layers. The first is the shade of the white of the eye that the professional seeks to reproduce. The second corresponds to the make-up: the vessels are reconstituted from wool threads to restore ...

3.4 Steps involved in fitting an ocular prosthesis

Each ocular prosthesis is entirely made-to-measure. A total of three appointments are required with the wearer before the final fitting. A follow-up visit is recommended every * months on average, for polishing. Another important aspect of the treatment is the time spent with the patient, explaining, informing, reassuring and comforting him or ...

3.5 Financing eye prostheses

The law regulates the prices (***). [***]

Link to the decree of October **, **** relating to ocular prostheses in chapter * of title II of the list of reimbursable products and services provided for in article L. ***-* of the social security code.

The ophthalmologist's prescription:

An ocular prosthesis requires a medical prescription from an ...

4.1 The different types of ocular prostheses

There are three main types of ocular prosthesis: the sceral lens, implant-supported mobility prostheses and orbital epitheses . [***]

Sceral lenses:

Sceral lenses are long-diameter contact lenses that pass over the cornea without touching it, covering the sclera (***). The lens can be rigid or flexible, with or without optical correction. The aesthetic result ...

4.2 The price of an ocular prosthesis

Table of prices for ocular prostheses by type :

Source: ****

The above prices are regulated by the French Social Security system . the most expensive prosthesis is the definitive ocular prosthesis after mutilating surgery (***) costs €**.**.

4.3 A limited and unevenly distributed offering

Source: ****

The map above shows the results of the search "ocular prosthesis" on Google Maps. The search returned ** results for eye prosthesis laboratories (***), which represents a good sample.

Eye prosthesis laboratories are unevenly distributed across France. There is a very high concentration of practices/labs in Paris (***). The Brittany and Centre ...

4.4 Innovation: towards the democratization of ocular prostheses?

First *D-printed eye prosthesis:

In ****, an English patient received the first artificial eye prosthesis designed entirely by a printer. By manufacturing the prosthesis using a *D printer, the valid eye can be reproduced almost identically.

Thanks to this innovation, the time taken to take charge, design, take impressions and obtain the ...

5.1 French regulations

Legal definition of the activity:

"Healthcare professional specializing in the fitting of ocular prostheses : he/she fits the non-functional eyeball or orbital cavity following enucleation or evisceration, with a custom-made external ocular prosthesis, to a sick or disabled person. He/she designs, measures and molds the prosthesis, manufactures it, has ...

6.1 Player segmentation

• Altuglas international France
• Dencott
• Cambrillat
• Villanova
• Prothelem
• Michel Durand sarl
• Pascal Oustalet
• Hôpital des Quinze-Vingts
• Hôpital fondation Adolphe de Rothschild