A Two-phase Procedure
(I. The Trial Shell and the II. Scleral Ocular Prosthesis)
 

Prior to the fitting of the (Phase II) custom made plastic scleral cover shell type prosthesis over a dysfunctional live eye, an impression moulded clear acrylic scleral trial shell (Phase I) must be fabricated and fitted.  This warrants a varied time frame determined by the degree of corneal sensitivity the patient may have.  This trial shell will serve a twofold purpose.  First, it allows the ocularist sufficient time to observe any possible rotation or displacement of the shell during blinking and normal eye movement, and to check for any pressure points (blanch areas) created on the underlying globe. Secondly, for the patient it is an orientation program, where a wearing schedule for 'tolerance and comfort' is arranged, allowing for time to adjust, accept and adapt to this foreign body, while simultaneously developing the skill of insertion, removal and its hygiene care.  The objective is to have the patient wear the trial shell all of his or her waking hours, and once this is accomplished the Phase II process would take place.

The following case presentations will acquaint you with various types of scleral cover shell prostheses that are available to embellish cosmesis while serving to physically, therapeutically and psychologically support the wearer after experiencing whatever caused the dysfunctional eye condition.