The artificial eye is a combination of science and art. A specialist is needed to create it, and through trial and error the artificial eye of today is much less detectable and fits much better than in the past. It is truly a work of art, as well, matched so closely with the person's other eye that many people don't even notice any discrepancy. But how did it get that way? How does it remain in place so well?

Many people use a maxillofacial surgeon or other facial doctor when they lose an eye, because they know that these kinds of doctors are well-trained in both facial reconstruction and prosthetics. As prosthetics become easier to work with, there will very likely be more doctors who undertake this kind of work, but a specialist with a lot of experience is still the best and most comfortable choice for most people who are facing facial reconstruction that includes an artificial eye.

When an artificial eye is created it is made to fit, through precision measurements, so that it will stay in place until the wearer dislodges it for cleaning or any other maintenance that it needs. Contrary to popular belief an artificial eye is not round like a marble, but rather thick and slightly concave, like a very heavy contact lens. The outer edges of it are contoured to fit a specific person's facial makeup, because everyone is just a little bit different in the exact size and shape of their eyes and the eye sockets.

After the prosthetic eye is made, the color must be matched to the original eye color of the patient. This might sound easy – eyes are brown, blue, green, or hazel – but it's much more complicated than it seems. A person with blue eyes might actually have blue-green, blue-grey, or blue-violet eyes, and what about all of the shades of green that are out there? Hazel is especially tricky, and even brown eyes can have many subtleties that make a person's eyes just a little bit different.

Only someone with a real eye for color can create something that looks so realistic and matches so perfectly with the person's eye color. Even the 'white' of the eye isn't completely white in most people. It is slightly shaded, and there are delicate blood vessels that can often be seen. An eye that is blinding white with a brightly-colored center and that doesn't have any visible blood vessels or irregularities doesn't look like a person's eye at all. It appears more like what would be seen on a porcelain doll. These can be very beautiful, but they aren't realistic and they look fake.

People who have lost an eye to disease or injury and have had it replaced with an artificial eye are generally a little self-conscious. An artificial eye can't move quite the same way an actual eye does, and the pupil does not expand and contract in reaction to light. With that in mind, the best way to make an artificial eye look as realistic as possible is through the art of matching color and characteristics to the patient's existing natural eye.