“The condition of the socket following disease ,severe trauma or birth defects, may not allow even the most skilled surgeon/ocularist team to produce a completely natural-looking artificial eye. The practitioner must therefore employ special techniques , known as “cosmetic optics”, to give the best cosmetic result for the artificial eye. It may be that the patient would like to wear a pair of cosmetically appealing spectacles with a slight smokey tint for added confidence in the initial stages of wearing their prosthesis or for safety reasons. It is a good idea to speak to your Ocularist about this especially if they are trained in the optical field. Vida is a qualified Dispensing Optician and assists her patients regularly in this aspect.


In cases of a too-narrow or too-wide lid opening, the use of a cylinder lens, by itself or in combination with plus or minus power lenses, will change the apparent shape of the lid opening. If the patients lid opening is too wide, start by holding a –3.00 cylinder over the patients artificial eye at axis 180, and then rotate the lens slightly in different directions. You will see the lid shape change and take on a more narrow look. Holding the lens at axis 90 will produce the opposite effect. The use of a minus cylinder to narrow the lid opening can also cause the iris to look smaller. In such cases, adding plus sphere power will neutralize this effect.


Anophthalmic patients often appear to have a sunken socket due to lower lid sag (from an unpegged artificial eye), an inferior orbit “blow-out” fracture, or from atrophy of orbital tissues. In such cases, a prism can be used to raise the apparent height of the orbit.

A prism is used to displace the image behind it. It works very well for a patient with a displaced socket. In the past, the prism added significant weight to the lens, but nowadays a press-on Fresnel prism, composed of a thin, flexible, wafer-like material that provides optical power and prism power to aid in image displacement, is used.

Ocularists, especially those with a background in optics, are often aware of the capabilities of cosmetic optics. Improved awareness and communication between our specialities will ensure optimum cosmetic rehabilitation of the anophthalmic patient.”

Excerp from “Movements” volume 4


We have a fully serviced, self-contained garden cottage with off street parking – all very safe and secure for our patients who are from far afield. Please arrange with reception at (021)-945 4926 for more details. We can also arrange to make and fit your prosthesis in full working day although we prefer at least two days. Once again, phone us to discuss possibilities.