Case study 8

Take home message:
If your eye is scarred and blind, don’t wait years before asking about scleral shells.
Scleral shells have excellent movement, very good retention and are comfortable to wear in most cases.Scleral shells are more complicated to make than artificial eyes because they are very thin.

Glossary of terms:
Phthisical eye : A condition of the eyeball that may result from injury when the eye loses function and shrinks in size.

Background:
Greg Matthews (not his real name) is a 31 year old giant who is also a top class kick boxing and cage fighting athlete. He has not let the fact that he can only see out of one eye stop him from pursuing this rigorous sport – but it has troubled him in other ways. Greg’s right eye was accidently damaged during a difficult birth and while surgeons offered to operate on it at the time, his parents refused because they could not bear to see him go through any more traumas. Indeed, the experience was so painful for them that they ignored his eye’s scarred appearance and never ever spoke about how it happened.

Partly because of this lack of acknowledgment and partly because of the serious teasing he suffered from other children at school, Greg ended up with very low self esteem and a shyness that limited his schooling and his ambitions. But talent has a way of shining through and Greg became a quality assurance manager. In his late twenties he met his present partner, Judith who has a master’s degree in psychology, and it wasn’t long before
she was suggesting to Greg that he should find out if anything could be done about the appearance of his damaged eye. Then she searched the internet and found Keith Pine.

Review of the eye:
Greg’s right iris was silver/white in colour and the eye had become phthisical with partially closed lids. Aside from these issues the eye was healthy and had good motility.

Treatment:
An impression was taken of Greg’s eyeball and a very thin acrylic shell was fashioned over the resultant mould. An iris was painted to match the good eye and positioned on the shell so that the direction of gaze could be determined. When the completed scleral shell was first fitted it rotated and settled out of position. However, this complication was soon addressed by reworking the shape of the shell. The final fitting went smoothly.Greg is amazed at how easy the whole process had been and how natural the scleral shell looks, moves and feels. He can’t believe he did not seek help years earlier and is especially grateful to Judith for pushing him into it. Now there is no holding him back because, even though the new eye hasn’t helped his fighting ability in the cage, it has boosted his confidence enormously in other areas of his life. Because Greg’s parents did not report his accident at the time it happened, a new claim had to be lodged by Greg’s GP in order for ACC to cover the cost of the shell and any future treatments.

Good luck for the future Greg – you have some catching up to do and we know you are very keen to get on with it. This man will go far.