Scleral Shells

Custom made to fit the exact curves of your anatomy, and reflect natural symmetry with your other eye.

A scleral shell is a thin prosthetic eye that fits directly over a blind and shrunken globe that has not been surgically removed. It is custom made to fit the exact contours of your remaining eye to restore volume loss and appearance. It includes the iris (the coloured part of the eye) and the sclera (the white part of the eye). It will, therefore, completely cover up an unsightly, deformed globe and restore a natural appearance.

Many individuals who have a disfigured blind eye are unaware that a scleral shell is a viable option that does not entail surgery. It is likely an option if the eye is stable, pain-free, and smaller than the companion eye.

Please get in touch with our office directly to book a consultation for more details and an evaluation of your specific condition. Many of our patients wish they had heard about scleral shells earlier. This type of prosthesis serves to increase the individual’s self-confidence and social interaction by restoring one’s natural appearance

Wearing the scleral shell I have restored that boost of self-assurance affirming my beauty inside and out, I feel vibrant now! Heartfelt thanks to Marie and her team for their life changing work that makes me feel I can take on the world.

– R.W.

What to Expect at Your Appointments

1

Consultation
We’ll review your history and evaluate the globe to determine whether you are a suitable candidate for a shell. We’ll also examine photos and samples and answer any questions you may have.

2

Pattern
An impression is taken in the clinic, as well as multiple measurements, colour matching, and the development of the basic shape.

3

Painting Shell
With the prosthesis half made, the details of the eye are painted by hand, regularly placing it back in the socket to check details.

4

Final Fitting
Any final adjustments are made, and we cover regular care and hygiene information, sign the paperwork, and send you out into the world with your new prosthesis.

5

Follow Up
Your prosthesis requires a repolish once per year, but you can also schedule an appointment for minor fitting adjustments or check-ins.

Ready to get started?

Care & Hygiene

A scleral shell prosthesis is removed nightly and stored in a safe container. Once you have gently removed your prosthesis, rub the surface firmly with liquid soap, water and a soft cloth to remove any protein deposit. Place your prosthesis in a safe container overnight. Never put it in a tissue or on the counter as it can be inadvertently discarded be either yourself or others.

If you experience mild discharge during the day, simply wet the end of a cotton-tipped applicator and softly rub it across the front surface of the prosthesis and your eyelids until clean. Often, discharge collects in the inner corner, so twist the cotton-tipped swab, and the discharge should wrap around it. If your discharge persists, worsens, or becomes yellow in colour, please see an eye doctor, as you may require drops.

Need to book your yearly check-up?

To Insert:
1. Place one finger over your top eyelashes and pull upwards to form a pocket to accommodate the eye.
2. Insert the eye under the top lid with the red dot on the prosthesis facing upwards.
3. While keeping a light, upward motion on the prosthesis, move your hand from the top eyelid to the lower eyelid and gently pull the lower lid down two or three times. The eye will slide into position behind the lids.

To Remove:
1. Wash your hands thoroughly. Open your eyelids with your thumb and forefinger.
2. Squeeze and firmly press a moistened suction cup over the center of the painted iris. Continue pushing backwards and release once in position.
The suction cup will adhere to the prosthesis if done correctly.
3. Look up, pull down on the lower lid and slide the prosthesis out and downwards over the lower lid using a suction cup handle.
OR look up and
depress the lower lid with your forefinger and move the finger away from your nose while pressing backward on the prosthesis. The prosthesis should slide out over the lower lid. Be ready to catch it as it dislodges.

Scleral shell prostheses are to be worn during daytime hours only. Because the globe remains, it is advised to remove the prosthesis before sleeping to allow the globe to rest and ease any potential pressure during sleeping hours.

The best way to clean a shell is with a mild liquid dish soap and water. With a wet, soft cloth, rub the entire surface of the prosthesis using moderate pressure. A protein deposit builds up on the surface and requires rubbing to remove. The deposit creates a dull appearance when dry, so rub until the luster is restored.

When handling it in the washroom, make certain the drain stopper is down and the toilet seat is closed, as the prosthesis can become slippery. Store in a small container in water overnight, away from children or animals. If you do not have clean water, please use a saline solution or distilled water. We will equip you with suction cups to help remove the prosthesis. If you require more suction cups, please get in touch with our office, and we will send you some.

Scleral shell prostheses are to be worn during daytime hours only. Because the globe remains, it is advised to remove the prosthesis before sleeping to allow the globe to rest and ease any potential pressure during sleeping hours. 

You will need to slowly build up your tolerance to the scleral shell over a few weeks to allow your underlying globe time to adjust to the prosthesis. Start by wearing your shell for 1-2 hours a day and add 1 hour each day until you can reach the ideal wearing time of inserting it in the morning and removing it before bed. 

If you do not have clean water, please use clean water and store it in a saline solution or distilled water. 

We will equip you with suction cups to help you remove the prosthesis. If you require more suction cups, please get in touch with our office, and we can send you some.

Shells typically last 5-7 years but depend on the underlying globe’s stability. If minor changes have taken place within that time, we can adjust/add to the prosthesis to accommodate them and extend the life of the prosthesis.

Your prosthesis requires a deep clean once a year! You must return to our office annually so we can repolish your prosthesis. This removes all the protein deposits and fine scratches from daily use. If your prosthesis requires any adjustments, please communicate when booking your appointment so we can allow appropriate timing in our schedule. The repolish appointment also allows us to evaluate the fit and cosmesis of your prosthesis and answer any questions you may have.

If you are experiencing dryness with your prostheses, first ensure you have been rubbing firmly while cleaning to remove protein deposits properly. If dryness persists, it may be time for your annual repolish appointment, but if it was polished recently, you may require the use of lubricating drops.

We recommend a gel drop as it is thicker and will alleviate longer. “Systane Gel Drops” are a good drop to start with. “Hylo Gel” or “Hylo Intense” are both very good for extra relief. You can place the drops right over the prosthesis while wearing it, but do not remove your eye too often, as this will create rubbing and discharge. If you have had radiation or your eyelids do not close completely, you may need an ointment for nighttime. We recommend “Refresh Lacrilube,” “Systane nighttime ointment,” and “OcuSoft Lid Scrubs.” Please read the label and use it as directed.

Consultations

You are welcome, at any time, to meet our team, hear about our process and see before and after photos. We can answer all your questions. We encourage you to explore our website as there is a lot of helpful information and photographs if you are unable to have a consultation. We can also arrange a telehealth video appointment if you are unable to travel to one of our offices.

Cost Coverage

Most BC residents are covered by the Fair Pharmacare Program, and eligibility is income-based. Therefore, coverage for each individual will be different.

Extended Health Care companies may cover a percentage of the balance after accessing any Pharmacare benefits. It is best to contact your extended healthcare provider for clarification. Please note that we can not directly bill any extended healthcare companies.

According to their policies, those with ICBC, WorkSafe, First Nations Health Authority, DVA, and Refugee status are eligible under these individual programs.

Please get in touch with our office if you require further details.

Book a consultation for a scleral shell prosthesis today.