The absence of an eye, whether following surgical loss or a congenital absence, is not only visually disabling but also affects the individual cosmetically and psychologically. To that end, the design and fitting of an ocular prosthesis in such patients by a skilled ocularist is of paramount importance. An excellent ocularist not only fits, shapes, and paints the ocular prosthesis but also guides the patient in the handling and care of the prosthesis. The techniques of making custom designed prostheses are presented, together with an overview of recent advances in this field. Cosmetic rehabilitation following exenteration or more extensive loss of facial tissue is discussed elsewhere.