Frequently Asked Questions:
is an impression moulded scleral ocular prosthesis?
is a flush fitting plastic shell type artificial eye with
varying thinness. It is made to cover an (acquired)
blind, scarred, disfigured, phthisical, deviated and/or dysfunctional
globe. They can also be categorized as a full thickness
scleral cover shell prosthesis for congenital microphthalmic
the scleral ocular prosthesis have any therapeutic purpose?
it can provide physical comfort and relief to patients with
dry eye syndrome, photophobia, and trichiasis. It also
provides a lifelike duplication of the fellow eye, which
is psychologically comforting to the wearer.
if my health insurance plan won't cover this fee for a scleral
prosthesis claiming it is strictly cosmetic?
Phase II cover shell prosthesis is covered by Medicare, Medicaid,
BCBS and most reliable HMO's in the New England states.
Of course, the end result would certainly be a cosmetic improvement,
which is part of the ocularists goal, but the primary purpose
of the scleral ocular prosthesis is to provide physical comfort
by restoring facial balance of the eyelids, and psychologically
comforting because it provides acceptance by oneself and
peers. Besides this it is a 'cost effective' procedure,
since the alternative for the health insurer would be provide
- surgical evisceration or enucleation of the eye of the
- implantation of a motility implant,
- the hospital and operating room expenses,
- post-operative antibiotic medications,
- impression moulded plastic ocular prosthesis.
there any other benefits derived from wearing such a cover
shell over a dysfunctional globe?
it can prevent surgical disruption (evisceration or enucleation)
of the orbital contents. It can also non-surgically
relieve the external adnexa by elevating a pseudo blepharoptosis
(sagging upper eyelid) caused by global volume loss (phthisis),
and in some cases reduce ectropion
by providing support to a prolapsed lower eyelid.
all of your scleral prosthetic referrals adults?
beside acquired conditions such as eye trauma, eye diseases
and post-operative surgical events resulting in phthisis,
disfigurement of the cornea or globe, we do have congenital
anomalies. These are birth defects of the eye and can
represent various stages of microphthalmos
(incomplete development of the eyeball).
is the procedure to having a scleral ocular prosthesis?
fabrication of the scleral prosthesis is done in two phases.
Phase I is a flush fitting clear acrylic scleral trial shell.
This procedure will assure us that you are a good candidate
for this type of prosthesis. This is best described
in detail in the Procedures
Section. Phase II involves the intricacies of simulating
your companion eye on and in the surface of the shell prosthesis.
This is also described in detail in the Procedure
I have a very sensitive cornea and cannot pass Phase I with
wearing comfort, but I still want this type of prosthesis,
what is my next option?
a Gundersen conjunctival flap to protect the cornea would
be the next option. A conjunctival flap eliminates
any corneal sensitivity, and you would be able to wear the
completed scleral prosthesis all your waking hours.
This matter can be discussed with your ophthalmologist.
it possible to wear a soft cosmetic corneal contact lens
over a blind disfigured eye?
if it is only the cornea that is scarred or disfigured.
The best cosmetic result would also require no loss of global
volume, and the eye have an aligned catoptric image (not