In the present contribution, we introduce a wireless optical communication-based system architecture that is shown to significantly improve the reliability and the spectral and power efficiency of the transcutaneous link in cochlear implants (CIs). We refer to the proposed system as an optical wireless cochlear implant (OWCI). In order to provide a quantified understanding of its design parameters, we establish a theoretical framework that takes into account the channel particularities, the integration area of the internal unit, the transceivers’ misalignment, and the characteristics of the optical units. To this end, we derive explicit expressions for the corresponding average signal-to-noise-ratio, outage probability, ergodic spectral efficiency and capacity of the transcutaneous optical link (TOL). These expressions are subsequently used to assess the dependence of the TOL’s communication quality on the transceivers’ design parameters and the corresponding channel’s characteristics. The offered analytic results are corroborated with respective results from Monte Carlo simulations. Our findings reveal that the OWCI is a particularly promising architecture that drastically increases the reliability and effectiveness of the CI TOL, whilst it requires considerably lower transmittal power when compared to the corresponding widely-used radio frequency (RF) solution.