Aesthetic and Functional Rehabilitation of Phthisis Bulbi Through Custom Scleral Shell Prosthesis: A Technical Case Report

This case report presents the fabrication of a custom scleral shell prosthesis for a young female patient with phthisis bulbi resulting from a childhood injury. Phthisis bulbi, an end-stage ocular condition, poses significant challenges due to its effects on orbital anatomy and function. The report describes the procedural steps involved, including impression making, cast fabrication, wax trial, iris orientation and matching, flasking, curing, characterization, and final finishing. Custom scleral shell prostheses are highlighted as a superior option compared to other prosthetic alternatives, as they allow precise customization, provide uniform pressure distribution, and offer improved aesthetics. The discussion emphasizes the importance of prosthetic design, anatomical considerations in phthisical eyes, biomechanical principles, material selection, and the need for customization. This approach not only restores appearance but also enhances psychological well-being and quality of life. The case underscores the need for ongoing interdisciplinary research and innovation to advance ocular prosthetics and improve patient outcomes.