When an eye has been damaged and cosmetically unbecoming, but does not need to be surgically removed, a scleral shell prosthesis is a good option. The scleral shell prosthesis is a very thin ocular prosthesis that is placed on the existing eye, much like a contact lens. Following the underlying eye’s movements, the scleral shell prosthesis moves completely naturally. The thickness of the scleral shell prosthesis depends on the size of the underlying eye. En eye that has lost its function tends to decrease in size. This has certain advantages for the prosthesis, as it needs a certain thickness to be cosmetically appealing – even if a scleral shell prosthesis can be as thin as 0,5 millimetre.
The creation of a scleral shell prosthesis differs a bit from the creation of a conventional ocular prosthesis. After making an imprint of the eye, we use a thin, transparent test prosthesis to mark out necessary positions. A thin acrylic shell is then created, copying the other eye’s colour. The scleral shell prosthesis is then finished and tried out. The completion of a custom-made scleral shell prosthesis normally requires three appointments.
Most patients with scleral shell prosthesis removes them before going to sleep, while some keep it in place day and night. This is individual, depending on the underlying eye’s reaction to the prosthesis, though we recommend removing the prosthesis before going to sleep. When removed, the prosthesis should be kept moist, for instance in fluid normally used for storing contact lenses.