American Society of Ocularist Standard Operating Procedures

The American Society of Ocularists is a not-for-profit, international organization founded more than 50 years ago by professionals specializing in the creation of prosthetic eyes. It seeks to educate the public and professionals about best practices regarding the creation and fitting of ocular prosthetics. The American Society of Ocularists also provides training to its members regarding these practices at its semi-annual meetings. The ASO's standard operating procedures fall into five categories.

Eyelid Reconstructive Surgeries

• These procedures, detailed on the ASO's website, help ocularists correct ptosis, or drooping, of the upper eye lid and lower eye lid laxity (sagging). These procedures also relate to entropion and ectropion repair, or correction of an eyelid that turns inward or outward excessively. These conditions commonly occur after years of wearing ocular prothetics.

Socket Reconstructive Procedures

• The ASO also provides standards for procedures correcting volume augmentation (sunkenness) caused by an artificial eye, and fornix reconstruction, which entails scarring to the pocket behind the lower eye lid.

Artificial Eye Motility

• The ASO offers guidance about whether ocular prosthetics should be pegged. Pegging allows an artificial eye to move side to side and up or down like a working eye would. Benefits and drawbacks to patients are discussed on the ASO's website.

Orbital Implants and Their Complications

• Before the 20th century, orbital implants were not used, which resulted in the eyelid sinking into a vacant eye cavity. Orbital implants correct this problem and allow an ocular prosthetic to be placed on top of the orbital implant. However, complications such as infection and irritation can result over time to patients with orbital implants. The ASO website details ways to alleviate the pain associated with these complications.

Primary Socket Procedures

• The benefits and drawbacks of enucleation surgery, evisceration surgery, exteneration surgery, and secondary orbital implant surgery are all discussed on the website. Enucleation refers to removal of the eyeball; evisceration refers to removal of all the inner parts of the eye such as the cornea, iris, lens and vitreous; secondary orbital implant surgery involves fixing a previous orbital implant that has become infected or has shifted position over time.