Normal Size Blind Exotropic Eye
(Scarred Cornea)
 

When there is deviation of the effected eye plus noticeable difference in the scleral whiteness and its vascular pattern, it becomes necessary to duplicate the thin Phase I clear acrylic trial shell in white acrylic.  This Phase II procedure is to scribe a pupil center and iris diameter that aligns with the fellow eye, then trim down the anterior surface and proceed to duplicate the overall surface of the normal eye.  All white acrylic removed prior to the painting is then replaced with a polymerized clear acrylic overlay.

Figure 8A This trauma induced exotropic left eye is wearing the acrylic clear trial shell and was well tolerated and could be worn for all her waking hours.

Figure 8B A white acrylic duplicate of the trial shell is then marked for pupil center and a scribed circumference for the iris painting.  The shell was thinned down to one fifth of a millimeter in preparation for the surface painting.

Figure 8C The scleral prosthesis is completed with clear acrylic over the painted surface which gives the iris an appearance of three-dimensional depth.