An ocularist creates custom artificial eyes for people who have lost an eye or need to have an eye removed. The process involves taking precise measurements, shaping and fitting the ocular prosthesis, and painting it. Although "stock" artificial eyes exist, the prostheses an ocularist crafts fit the wearer precisely. An ocularist's job is quite different than that of an oculist; the latter is a somewhat outdated and general term for a medical eye specialist, whether an optician, an optometrist, or an ophthalmologist.
To begin the process of fitting a new artificial eye, an ocularist makes an impression, or cast, of the eye socket. The impression shapes a plastic mold — the mold for the actual prosthesis, which is made of acrylic. The ocularist makes the basic prosthesis in the mold, then precisely shapes it as necessary, and paints the white, iris, and pupil using the patient's other eye as a model. After a final fitting to assess shape and color-matching, he or she instructs the patient on proper care and maintenance of the new prosthesis.
Besides the physical aspects of fitting, shaping, and painting prosthetic eyes, ocularists may need a delicate touch in dealing with patients who have been through the traumatic loss of an eye, who are often in physical pain and experiencing trepidation about their future. There are some subspecialty areas for ocularists, such as pediatric eye replacement; implants that can move, simulating normal eye tracking; and scleral shells, which fit over a disfigured or discolored but functional eye, restoring its appearance. Although their services are more commonly called on for human eye replacement, some ocularists may provide custom eye prostheses for animals that have lost an eye.
Unlike many other medical or medical-adjacent specialists, ocularists do not have special schools or attain specialized degrees. In the United States, according to the American Society of Ocularists (ASO), ocularist training requires an apprenticeship. Before training, the ASO recommends a grounding in science as well as art, specifically painting and sculpture, to those interested in pursuing a career in ocular prostheses.
Despite its name, the ASO is an international board. The ASO, which certifies ocularists, requires the apprentice to study all aspects of ocular prosthetics and spend several years undergoing practical training. The organization also offers classes at its semiannual meetings in the areas of fitting, fabrication techniques, tinting, anatomy and physiology, and hygiene, among others. After training, an ocularist may be certified by the National Examining Board of Ocularists on completing a written and practical exam.