Foldable iris prosthesiscustom-made

for each patient

Order Form / Prescribtion (Rx)

I herewith prescribe with my signature at the

bottom of this form a custom-made ArtificialIris

for the following patient:

Colour Template: A photo print-out (hard copy)

is needed as colour template for the production

of the ArtificialIris. Please submit your photo of

each eye and label the one that shall serve as

template for production.

Attachment: photo print-outs of both eyes, one

print-out labelled

Hard Copy Picture

The ordering is done directly to

Dr. Schmidt (HumanOptics).

There is no colormatch chart.

You will need to obtain a HARD

COPY picture of the uninjured iris, the partially

injured iris, or both (or a

desired iris appearance for a

congenital aniridic).

You will send the hard copy

(not email) picture to Dr.

Schmidt and they will manufacture the patient's

CustomFlex iris to match the picture which you send.

Hard Copy Picture - Photo Directives

Hard Copy Picture - Photo Directives

Compare your print-out with the natural iris!

Hard Copy Picture – example professional photographer

Hard Copy Picture – example professional photographer

Hard Copy Picture - “White balancing”

Sample: two independent fiber optic light sources, no flash

Dr. M. Snyder, USA

July 2009; sulcus placement after trauma, suture fixation over sutured IOL

pre-op post-op October 2009

Hard Copy Picture - Example full implant pre- and post-op

Dr. Schmidt Intraocularlinsen GmbH

Westerwaldstraße 11-1353757 Sankt Augustin / Germany

www.artificial-iris.com

iris@humanoptics.com

Thank you for your attention!