Facial and Smile Symmetry: Customized Iris Positioning Device for Enhancing the Realism of Ocular Prostheses

The eyes, being one of the most prominent facial features, play a crucial role in facial symmetry and are subject to extensive scrutiny in terms of their morphological and functional aspects. Numerous studies have explored the association between facial symmetry and the morphology of the eyes. Symmetrical faces are generally perceived as more attractive and are believed to indicate good genetic health. As a result, research has focused on the measurements of ocular symmetry, including inter-eye distance, eye shape, and eyelid symmetry. It has been found that individuals with more symmetrical eyes are often perceived as more attractive and exhibit enhanced social desirability. The eyes play a crucial role in facial expression and are vital sensory organs. A 49-year-old patient presented with a chief complaint of facial disfigurement due to shrunken right eyelids resulting from trauma-related evisceration. Various techniques for iris positioning have been reported in the literature, but they have had limitations. This clinical report presents an improved and effective technique utilizing a customized iris positioning device, consisting of a transparent graph sheet attached to a forehead clip. The customized ocular prosthesis significantly improved the patient’s quality of life and restored her self-confidence. The customized iris positioning device offered enhanced proximity to the eye and provided several advantages, including accurate pupil centralization, customization, re-verification, and being cost-effective.