Background: Loss of an eye, whether secondary to trauma, infection, or malignancy, produces significant functional and psychosocial consequences. While conventional stock prostheses offer a basic rehabilitative option, custom-made ocular prostheses provide superior esthetics, fit, and patient satisfaction. A recurring clinical problem in anophthalmic patients is socket dryness arising from disrupted tear dynamics, which causes discomfort and may accelerate conjunctival deterioration. This report describes a case in which both challenges—socket dryness and imprecise iris positioning—were simultaneously addressed through a purpose-built prosthetic design and a digital alignment technique.

Case Report: A 32-year-old male presented fifteen years after traumatic evisceration of the left eye. He had never been fitted with a prosthesis. A custom hollow acrylic ocular prosthesis was fabricated incorporating an internal lubricant reservoir, sealed by an adapted insulin syringe plunger cap and connected to the socket surface via a precision exit hole. Iris positioning was accomplished by overlaying a graph-grid on an eyewear frame and cross-referencing the iris coordinates in real time using an augmented reality (AR) Golden Ratio facial filter. The prosthesis was evaluated across all planes of ocular movement and found to meet clinical and esthetic criteria.