Todd Cranmore leans in close to his patient Tim, close enough for Tim to feel his breath. Cranmore sizes up the geometry of Tim’s left eye.
“So I’m getting set up to put your pupil in,” Cranmore tells him. “What I want to do is set your pupil first, because it’s going to be offset, then all the radial patterns I want to paint out.”
With the pupil is place on a dime-size curved disc of acrylic, Cranmore sets to work painting. He mixes dry pigments with solvent on a mat, and deftly streaks the plastic iris with grays and yellows.
The Department of Motor Vehicles would say Tim’s eyes are blue, but Todd Cranmore knows better.
“I don’t see blue,” he says. “Most blue eyes are predominantly gray.”
Todd Cranmore is deconstructing the layers, colors and anatomy of Tim’s eye in order to make a perfect duplication. He’s an ocularist, or maker of artificial eyes, and his artwork will be set into a larger concave piece of acrylic and fitted into Tim’s right socket as a prosthesis.
In walks the lab’s senior ocularist Christie Erickson to appraise Todd’s work.
Erickson Labs Northwest in Kirkland is one of just four licensed ocularist practices in Washington. They make eyes for people who have lost or damaged their own eyes because of accidents, cancer or birth defects. Each eye is hand-painted using the live eye as a model, when possible, as Christie or Todd tries to capture the exquisite character of the human eye.
“There’s nothing else on our bodies that are that captivating. Kind of like a flower, it’s the beacon, it’s the life, it’s the window to the soul,” he says. “What a challenge to try and duplicate an iris, and make something that is plastic and pigment look alive.”
Making it come alive flows in part from watching the person’s whole face, understanding how the eye reads to other people as an expression of the patient’s personality. In this patient’s case, Todd has the advantage of knowing the eye well. Tim is Todd Cranmore’s older brother. Christie Erickson is their mother.
How Tim wound up as his brother’s patient in an eye shop owed by his mother involves freakish chance, a family’s radical change in direction and exquisite attention to detail.
In the summer of 1976, the Cranmores lived in a rural spot outside of Monroe, Wash.. The family was hosting a holiday gathering around July 4th to celebrate the arrival of their first daughter Colleen a few weeks earlier. Tim was three years old and Todd was one-and-a-half.
At one point Christie’s husband — Tim and Todd’s father — and his brother decided to take on a project: A bolt on their backhoe needed to be removed. The thing seemed so stubborn it must have been made of tempered steel. They grabbed a pair of bolt cutters to do the job.
“Of course being a young boy I wanted to go out with them,” Tim says. “I remember him saying, ‘no, no, stay here,’ and I put up a pretty big fuss that I wanted to go out. So they finally agreed to let me go out and watch.”
Tim prevailed. His dad said he could watch from a distance as the men struggled with the bolt. Finally, the cutters bit steel. A fragment shot out.
It hit Tim in his right eye.
“I remember him picking me up and looking at me all concerned,” Tim says. “And I remember looking at him and saw a little bit of blood above his eyebrow. I was worried about him because I actually saw blood. I couldn’t figure out why they were looking at me, I don’t remember feeling any pain.”
Christie remembers her husband at the door, Tim folded in his arms and crying softly, telling her he was heading to the emergency room. Christie followed with the baby. The doctors told Christie they weren’t sure the eye can be saved – they’d have to see what the ophthalmologist said after emergency surgery that night.
“The ophthalmologist surgeon, he came out and told us it was all collapsed, and that it looked like something exploded inside Tim’s eye,” Christie remembers.
Finding A Replacement
Christie feared Tim’s injury would rob him of a normal childhood, that he’d be unable to ride a bike or play a sport. To her relief, Tim proved resilient, more coordinated, perhaps, than even his own siblings.
But the eye itself began to shrink back into its socket. By the time Tim was ready to start kindergarten, his parents became concerned about how other kids would treat him.
Around that time she heard about the possibility of getting something called a scleral shell — a concave piece of plastic that worked a bit like an oversized contact lens, with a customized, hand-painted copy of Tim’s good eye.
“I met Gerald Erickson, the ocularist. I was really impressed with the office. I met other patients and even there was a child,” she recalls. “It was just a close secure feeling to have, to be understood.”
To Christie, Erickson’s office felt comfortable and the process was fascinating — she’d always had a potent artistic streak, and eye-making seemed thrilling to her. And Erickson, the craftsman, was intriguing too.
“I was drawn, I was appreciative,” Christie says. “I saw (Jerry) as, not a knight in shining armor, but close to it.”
Christie’s marriage had not been bearing up well in the aftermath of the accident.
“The trauma of what happened to Tim was very severe,” she says. “I was told that when tragedies like this happen it’ll either strengthen a marriage or break it up. And in our case, it broke it up.”
Eventually, Christie and her husband got divorced, and she married Jerry Erickson. Christie began helping out around her new husband’s office. Before long she became his apprentice, and later his colleague.
A Series Of Adjustments
With his prosthesis in, Tim Cranmore looked very much like any other kid. But it’s impossible to keep everyone from finding out one of their classmates has an artificial eye.
“Everybody would want to see it, they’d want me to take it out,” Tim remembers. “They’d conjure up a quarter or fifty cents or whatever. And I didn’t really care about the amount, it was more of a peer-pressure thing.
“One person would ask and all of a sudden you’d have a whole group of kids around you waiting for you to take out your eye. I definitely hated it. I didn’t want the attention.”
As Tim got older, social settings got easier. But an artificial eye always has a few tells. The pupil doesn’t dilate — so in certain kinds of light there is a mismatch between the two eyes. And while the prosthetic eye can move, it doesn’t track exactly with the other eye.
Tim recognizes when people notice something is off.
“You can tell right away when people are comparing eyes or if they’re concentrating on my prosthesis, I’ll try to divert their attention a little bit or maybe pull back a little bit. When I was younger, I was very hesitant to make eye contact. I was always kind of looking down,” he says.
Tim is willing to talk about it when asked. Often, people are empathetic or genuinely curious. But given the value we place in eyes, the way we instinctively read eyes to understand a person, some people won’t or can’t get comfortable with a person who is missing one.
“I’ve had some dates in the past when the subject of the eye comes up, you know you have five, great dates in a row, things seem to be going really well. And as soon as they go, ‘oh what’s wrong with your eye?’ And I tell them what happened, and that’s the last you hear from them,” Tim says.
At least with a convincing prosthesis Cranmore has some choice about how forward he wants to be. He’s grateful for that, and considers it a testament to the craftsmanship of his mother and brother.
“I feel blessed to have this option, instead of just wearing a patch over your eye and just being a pirate the rest of your life or something,” Tim says. “It’s kind of nice to just be an everyday person.”
Taking The Long View
Artificial eyes have been made more-or-less the way they are now, hand-painted on acrylic in the presence of a human model, since World War II. That’s when the war made the special German-blown glass used for glass eyes unavailable.
Some ocularist practices have tried to automate parts of the process. A few offer irises printed with digital imagery. But for Christie Erickson and Todd Cranomre, the direct personal interaction is crucial.
“There’s a human component that’s getting captured because we’re sitting here and chatting and painting, and so your eye as we’re talking is very lively. I think a lot of that is getting captured in our painting,” Todd tells Tim. “When it’s not for real, when it’s not going to be in someone’s face, it’s not going to be the same.”
Todd is back to work on Tim’s eye. It looks as if the two brothers have relapsed into a childhood staring contest.
“It’s hard not to laugh,” says Tim.
Cranmore is putting the finishing touches on Tim’s iris, now layered so intricately with paint that the pigments recreate the folds and furrows of Tim’s actual tissue. But the eye has to do more than look good — it needs to fit perfectly.
For that, Todd has to take an impression of Tim’s eye socket. As Tim reclines in an exam chair, Todd injects a gel into the socket, which solidifies within a few minutes. It’s very much like a dental impression, and it’s the least pleasant part for most patients.
The mold is used to shape the concave shell. The iris will be inset, and Todd will carefully fray red silk thread to recreate the blood vessels — it’s important to be well-rested when you sit for a new eye, Tim explains, or your prosthetic could wind up looking bloodshot.
The result is a prosthesis that is nearly indistinguishable from the natural eye.
“Oh, what a beautiful iris,” Christie says, admiring the nearly finished product.
After four decades of following the unexpected course that Tim’s injury nudged their lives onto, Christie and Todd are able, in some way, to repair the damage from that original event. Their lives have come full circle in a way Christie says she never could have predicted.
Over the next five years or so, this eye will go to sleep with Tim and wake with him, it will droop after long days at the office and, in all likelihood, cry with him (Tim still has his tear ducts). It will appear in all the family photos.
After all, both of Tim’s eyes are gifts from his family.
“I think it’s a neat thing to be able to hand over the mirror and be able to let go and say here’s this thing we made,” says Todd. “It’s my hands, it’s my mom’s hands, but I want my brother to have ownership and to feel that it’s his eye. It’s not our eye any longer. It’s his eye.”