Dysfunctional Globes (various types of scleral shells)

A properly fitted ocular prosthesis that is lifelike in appearance is basically both a physical and psychological comfort to the patient, especially if it is accompanied with synchronous movement with the companion eye. This is why most ocularists prefer to fit flush fitting scleral shell type prostheses to cover dysfunctional globes. The vision may be lost, the eye may be disfigured and even malpositioned, but, other than that, there is no disruption of the extraocular muscles and little displacement of orbital tissues. Years ago such an eye would be enucleated as a precautionary measure since it could harbor a malignant tumor or may cause sympathetic ophthalmia. However, medical science has developed ultrasound equipment and magnetic resonance imaging to detect such intraocular foreign bodies. The ocularist profession in like fashion responded with acrylic prostheses that can be flush fitting and made as thin as a fingernail for such cases that are diagnosed as normal sized blind, scarred disfigured globes to exophthalmos and other deviations from the norm. A scleral contact shell type ocular prosthesis had been a rarity more than forty years ago, and now its acceptance is such that it involves more than 30 percent of our case referrals.