Scleral Shells: A Comprehensive Guide

For those living with an eye that has been damaged, a scleral shell can be a life-changing solution. Designed to fit comfortably over a non-functioning or disfigured eye, these custom-made prosthetic shells restore a natural appearance while also providing protection and comfort.

Understanding how scleral shells work, who they’re designed for, and what to expect during the fitting process can help you determine if this option is right for you. This guide will walk you through everything you need to know, from benefits to care and maintenance.

What Is a Scleral Shell?

A scleral shell is a thin, custom-made prosthetic device designed to cover a damaged or non-seeing eye. Unlike a full ocular prosthesis, which replaces a surgically removed eye, a scleral shell is made to fit over a shrunken or damaged globe.

Scleral shells are crafted with precision to match the appearance of the patient’s companion eye, restoring symmetry and improving comfort.

Each scleral shell is uniquely designed for the individual, ensuring a secure and comfortable fit. Made from high-quality medical-grade acrylic, these prosthetic devices are lightweight, durable, and carefully painted to replicate the natural details of the companion eye.

The goal is to create a seamless, lifelike appearance while also protecting the delicate tissue of the affected eye.

Who Can Benefit from a Scleral Shell?

Scleral shells are ideal for individuals who have lost vision in one eye but have not undergone enucleation (surgical eye removal). They are commonly used in cases such as:

Severe Eye Trauma: Injuries from accidents or surgeries may leave an eye damaged, shrunken, or misshapen. A scleral shell can restore a more balanced facial appearance.
Microphthalmia: Some people are born with an underdeveloped eye, which may appear much smaller than the companion eye. A scleral shell can improve symmetry while maintaining comfort.
Post-Surgical Cases: After certain medical treatments or surgeries, an eye may no longer function but still remains in place. A scleral shell helps maintain a natural look without requiring full eye removal.

A scleral shell can be a valuable, life-changing solution for those struggling with appearance or discomfort due to a damaged eye. It provides a natural look while also improving comfort, making everyday life easier and more confident.

How Scleral Shells Improve Quality of Life

Living with a damaged or non-seeing eye can be challenging, both physically and emotionally. A scleral shell can help in many ways, improving not just appearance but also comfort and confidence.

Restoring a Natural Look: A well-crafted scleral shell is designed to closely match the companion eye in size, shape, and color. This creates a balanced, natural look, allowing individuals to feel more comfortable in social and professional settings.
Boosting Confidence: Many people with a disfigured or shrunken eye feel self-conscious. A scleral shell helps restore symmetry, which can make a big difference in how someone sees themselves and interacts with others.
Providing Comfort: Some damaged eyes are painful or sensitive to light. A properly fitted scleral shell offers a protective covering that can reduce discomfort and irritation.
Preventing Further Changes: When an eye shrinks or changes over time, the surrounding tissue can also be affected. A scleral shell helps maintain the shape and health of the eye socket, preventing future complications.

For many people, the impact of a scleral shell goes beyond physical appearance. It can restore confidence, reduce discomfort, and make everyday life easier.

The Process of Getting a Scleral Shell

Getting a scleral shell involves a step-by-step process to ensure a comfortable fit and natural look. While each experience is unique, here’s what you can expect:

Initial Consultation: The first step is a detailed evaluation. An ocularist will assess the condition of your eye, discuss your needs, and explain the process.
Taking an Impression: To create a custom fit, a mold of the eye socket is made. This ensures the shell sits securely and comfortably without irritation.
Customization & Painting: Once the shell is shaped, it’s hand-painted to match the color and details of your natural eye. This artistic process is crucial in creating a realistic, lifelike appearance.
Fitting & Adjustments: The scleral shell is carefully placed and adjusted for comfort. Small refinements are made to ensure it feels right and looks as natural as possible.
Follow-Up Care: After wearing the shell for a few weeks, a follow-up appointment may be needed. Ongoing care is important to maintain comfort and longevity.

With the right care and expertise, the process is smooth and ensures the best possible result for each individual.

Pros and Cons of Scleral Shells

Like any medical solution, scleral shells have both advantages and limitations. Understanding these can help you make an informed decision.

Pros

Restores Facial Symmetry: Helps create a balanced, natural appearance.
Custom-Fitted for Comfort: Designed to fit securely without irritation.
Non-Invasive Solution: No surgery required. The eye remains intact.
Helps Relieve Discomfort: Can reduce irritation and sensitivity in a blind or damaged eye.
Allows for Some Natural Eye Movement: Unlike a full prosthetic, the shell moves with the existing eye.

Cons

Requires Maintenance: Regular cleaning and care are needed to keep it in good condition.
Not Suitable for All Cases: Some patients with excessive eye shrinkage may not be ideal candidates.
Adjustment Period: It may take time to get used to wearing a scleral shell.
Occasional Refitting Needed: As the eye socket changes over time, adjustments or replacements may be necessary.

For many individuals, the benefits of a scleral shell far outweigh the challenges. Proper care and expert fitting can provide long-term comfort and confidence.

Caring for a Scleral Shell

A scleral shell is an investment in both comfort and confidence. Taking proper care of it ensures that it stays in great condition and continues to fit comfortably. Here are some key steps to keep your prosthesis clean and long-lasting.

Cleaning Routine

Wash your hands thoroughly before handling your scleral shell.
Use a recommended saline or cleaning solution to rinse the shell, avoiding harsh chemicals.
Gently wipe away any debris with a soft, lint-free cloth.

Handling & Storage Tips

Always store your shell in a protective container with water when not in use.
Avoid dropping it on hard surfaces to prevent scratches or damage.
Use distilled water when cleaning or storing.

When to Get Adjustments

If the shell begins to feel uncomfortable or causes irritation, a refitting may be needed.
Changes in eye shape over time can affect the fit. Regular check-ups ensure ongoing comfort.
If discoloration or buildup occurs despite proper cleaning, professional polishing can restore its clarity.

A well-maintained scleral shell can last for years with the right care. Sticking to a cleaning routine and scheduling regular follow-ups will help keep it in top shape.

Find Expert Care for Your Scleral Shell Needs

A scleral shell restores appearance while providing confidence, comfort, and peace of mind. Eye Concern specializes in crafting high-quality, custom-fitted scleral shells that look natural and feel comfortable. Our experienced team is here to guide you through every step, ensuring you receive the best possible care.

If you’re considering a scleral shell or need support with an existing one, we’re here to help. Contact Eye Concern today to schedule a consultation and take the next step toward a solution that works for you.