To show that scleral shells can be good cosmetic prostheses for phthisis bulbi or discolored blind eyes for which no evisceration or enucleation is indicated.

Twenty patients with phthisis bulbi or discolored blind eyes were enrolled in this study. All patients were using scleral shells. We evaluated any complications induced by the scleral shells and the cosmetic results during the follow-up period.

The average central thickness of the scleral shell was 1.84±0.26 mm, and the average volume was 1.52±0.25 ml. The average difference in palpebral fissure width between the fellow eye and the eye with a fitted scleral shell was 0.8±0.62 mm. One patient complained about ocular irritation and difficulty in fitting but was satisfied with the cosmetic appearance.

Fitting scleral cover shells over phthisis bulbi or discolored blind eyes without evisceration or enucleation could be a successful remedy for enhancing cosmetic appearance.