Vida Trümpelmann
Scleral Shells:
A scleral shell is fitted when a patient has damaged his or her existing eye, lost sight in the eye and the eye has become unsightly. It could be that a patient has had a series of operations to save the sight of the eye but the outcome has been loss of sight and a slightly shrunken, unsightly eye that remains. Sometimes a baby is born with an underdeveloped eye (Micro-ophthalmos). Often there is no sight or even light perception experienced by these patients. It is however a concern for the family and close friends that the cosmesis be dealt with for later years, when the child starts school. For social reasons it is important to deal with the problem as early as possible.
The scleral shell is a thin lens made to fit over the existing eye and has the iris and the sclera matched to the other one. It moves in conjunction with the other eye. There is also the concern for development of soft tissue and bony tissue of the orbit with respect to the growth of the young child. It has been found that if a shell is not fitted within the early developmental years a marked difference in symmetry could be noticed in later years.
It is important to fit these scleral shells with co-operation of the patient to avoid injury to the existing globe. We therefore suggest that parents come and see us with their little one from a very early age (3-6 months).
It is sometimes necessary to have the impression for the shell taken in theatre while the child is under anaesthetic. It is a very short procedure and totally painless for the patient. This will be discussed in more detail on consultation. Mostly, the impressions are done at the practice.
It is not necessary for adults or older children to go to theatre for the impression.
