Removable eye cartridges let trainees examine their work. (Photo: Carla Johnson)

Not long ago, people learning to perform trichiasis surgery practiced their cutting and suturing skills on oranges. From orange rinds, they went straight to live surgery.

With millions of people in Africa and Asia in need of trichiasis surgery to preserve their sight, Emily Gower, an epidemiologist and trachoma expert at the Wake Forest School of Medicine, knew there had to be a better way.

So Gower went to Jim Johnson, executive director of the Wake Forest Center for Applied Learning, who studies how adults learn new skills. As Johnson saw it, the budding trichiasis surgeons needed to practice on something more lifelike. The highly trained special-effects artists at Johnson’s company, Human Analogue Applications, got to work, using silicone and other substances to fashion the anatomical layers of the human eyelid.

The result was HEAD START, a brown-eyed, silicone mannequin that gazes patiently upward as students swath it in sterile drapes and cut into its orbicularis muscle, tarsal plate and conjunctiva. Crucial to the design are the dummy’s removable eyelids, which allow trainees to examine the precision of their work.

A full version of this article was originally available on USAID’s MMDP Project website. The MMDP Project closed in 2019.