PROSE Treatment

About BostonSight® PROSE Treatment

Q. Is there medical research on the effectiveness of BostonSight PROSE treatment?

A. The prosthetic devices used in BostonSight PROSE have been approved by the FDA since 1994 for the treatment of ectasia and ocular surface disease (including dry eye). We have over 40 peer-reviewed research papers, publications and talks documenting the impact of PROSE treatment, including a 2009 study published in the American Journal of Ophthalmology that determined that BostonSight PROSE "improved visual acuity and visual functioning in patients with corneal ectasia, irregular astigmatism, and ocular surface disease..." See for a complete list.

Q. What are the steps in the BostonSight PROSE treatment process?

A. The steps are:

1. Referral from your primary eye care provider, medical doctor or cornea specialist
2. Initial medical review by PROSE doctors
3. 2-3 hour consultation to assess candidacy; your PROSE treatment team will then work with you to identify treatment goals and determine whether PROSE treatment is a good option for you.
4. Determination of insurance coverage and potential eligibility for financial assistance (2 - 6 weeks)
5. PROSE treatment (4 - 12 day-long visits)
6. Periodic follow up visits as required by your PROSE provider, primary eye care professional or specialist
7. Annual evaluation by your PROSE provider

Patients continue to be followed by their primary eye care provider during treatment and after, and ongoing care is coordinated with primary providers and the PROSE treatment team as required.

Q. How long does BostonSight PROSE treatment take to complete and what is involved?

A. BostonSight PROSE takes approximately 4-12 full business days, and includes customizing multiple trial prosthetic devices, each step followed by a trial wearing session, in order to achieve the best customization possible. An optimal customization is critical not only for comfort and improved vision, but also necessary for the prosthetic device to successfully replace and/or support the healing of damaged ocular surface system functions. The final prosthetic device or set of prosthetic devices is unique to each patient’s eye shape, disease profile, and specific treatment goals.

These 4-12 days include typically at least three sessions for training in the care of your prosthetic devices, including handling, cleaning, storing, and application and removal, to ensure that every patient is comfortable and confident in their use. It is not unusual for a patient to require 5-10 training sessions, during the course of prosthetic device customizations. Patients that live nearby a PROSE provider may space out their visits during the treatment process, extending the time between initial consultation, the start of the customization process and completion of the customization process.

Q. Can I try the PROSE devices first without making a commitment? If so, will I be able to tell how much they will help me?

A. Yes. When patients come for an initial 2-3 hour consultation trial prosthetic devices will be placed on the eye(s) to determine potential improvement in vision and relief of symptoms.
Before going through what can be an intensive customization process, our doctors will conduct a thorough exam and apply one or more trial prosthetic devices during the consultation. While some patients do experience significant symptom relief almost immediately, others get increasing benefit over time. Initially, the actual feel of the trial prosthetic devices varies from patient to patient and may be imperfect at best. Trial devices may not have your optical correction, but this can be simulated with trial glasses that will be close to the best vision that can be achieved.  At that point your PROSE treatment team will work with you to determine whether PROSE treatment is the best choice for you.

Q. What about the part of the eye that is not covered by the device—will it still hurt?

A. PROSE devices are designed to rest on the relatively insensitive sclera, or white part of the eye; they do not touch the cornea. Each prosthetic device is custom designed and manufactured  to provide optimal comfort, visual function and symptom relief for each patient’s specific needs.  The size of the PROSE device and the amount of eye that remains exposed will vary from patient to patient.

Q. If I were wearing PROSE devices would I be able to work at a computer again?

A. PROSE treatment outcomes are dependent upon the individual patient. Some patients who were unable to use a computer for extended periods of time find this task is manageable after receiving PROSE. Others may benefit from additional aids such as lubricating drops, moisture chamber goggles or computer glasses.