Prosthetic contact lenses provide an important therapeutic tool in the treatment of diseased and disfigured eyes. For many patients, a prosthetic contact lens is the most attractive option available to them. This article discusses general clinical fitting considerations of prosthetic lenses and highlights the use of a opaque hydrogel prosthetic lens with a decompensated cornea secondary to failed keratoplasties. Iris painted contact lenses are good cosmetic prostheses for disfigured or blind eyes for which no evisceration or enucleation is indicated. Prosthetic contact lenses may be indicated over clear corneas or heavily scarred corneas. It’s far less invasive than the surgery required for enucleation and a prosthetic eye fitting, and it’s much more appealing than just wearing dark sunglasses.