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the 2008 prosthesis, the trimmed wax model Conclusion
for the new 2018 prosthesis, and that same To design an ocular prosthesis that is mechanically and
model with further modifications (shown in cosmetically acceptable requires a high degree of analysis of
red). the patient’s socket, the orbital implant or lack thereof, the
The wax model was finished with the eyelids, and the surrounding tissues. In a perfect world, all of
placement of an iris button. After casting these components would work together to support an ocular
the wax model and processing, the anterior prosthesis in a position that mirrors the companion eye and
surface of the acrylic duplicate was cut back eye lids. Unfortunately, we do not live in a perfect world but
and then painted. The finished prosthesis was rather a world in which human bodies are constantly changing
delivered to the patient and is shown in Figure with age. Consequently, we ocularists must do the best that we
6. When the two eyes are compared, one can can for our patients given the physical condition in which we
see that the socket and the surrounding tis- find them.
sues on the right side are markedly lower than
those on the left side. References
The author and the patient were satis- 1. Farkas JP, Pressa JE, Hubbard B, Rohrich RK (2013) The
fied, given the circumstances, with the fit of science and theory behind facial aging.American Society of
the new prosthesis, but the author was not Plastic Surgeons. Available at: www.researchgate.net/pub-
satisfied with the value of the iris. He advised lication/266624746_The_Science_and_Theory_behind_Fa-
the patient to return in 2 weeks for a color cial_Aging. Accessed: March 23, 2020.
adjustment and the patient was given an 2. Coleman SR, Grover R (2006) The anatomy of the aging
appointment time and date. The patient face: Volume loss and changes in 3-dimensional topogra-
did not keep his appointment. The author phy. J Aesthetic Surg Jan-Feb:S4-S9 (Suppl)
anticipates that he will see the patient again
sometime in 2028. 3. Lambros V (2007) Observations on periorbital and midface
aging. Plast Reconstr Surg 1210(5):1367-1376
Established in 2017 by the
American Society of Ocularists, our

mission is to provide the highest
quality educational experience to
Established in 2017 by the American Society
of Ocularists, our mission is to provide the highest
students of Ocularistry.
quality educational experience to students of Ocularistry.

The ASO, College of Ocularistry (COO)
COO Courses The ASO, College of Ocularistry (COO) offers a five year (minimum) education
offers a five year (minimum) education pro- program. This program supplements your on-the- job training with academic
and Workshops
courses and hands- on instruction provided by Board Approved Diplomate
gram. This program supplements your on-the- COO Courses and
Ocularists, ophthalmologists, and professionals from related fields.
job training with academic courses and hands-
on instruction provided by Board Approved Dip- Workshops
lomate Ocularists, ophthalmologists, and pro-
fessionals from related fields.

Lab Skills Workshop held at Iris Painting Workshop Fitting Techniques Course
local Ocularist’s office

For more information go to: ocularist.org and click on the College link.
Lab Skills Workshop held at Iris Painting Workshop
local Ocularist’s office Fitting Techniques Course
For more information go to: ocularists.org and click on the College link.
JOURNAL OF OPHTHALMIC PROSTHETICS AGE RELATED CHANGES TO THE PERIORBITAL AND MIDFACE | 19
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