Eye Enucleation

Eye Enucleation and Ocular Prostheses

Eye enucleation refers to the complete removal of the eye along with part of the optic nerve. This procedure is usually performed for the following reasons:

Severe eye trauma leading to total vision loss.
Irritation, discomfort, blindness, severe pain, or structural deformity of the eye, sometimes occurring after glaucoma, retinal detachment, or chronic inflammatory conditions.
A non-functional eye that poses a potential risk of inflammation and blindness in the healthy eye.
Intraocular tumors that cannot be treated with other methods.

Surgical Methods for Eye Removal

Enucleation: Detaching the eye muscles, cutting the Tenon’s capsule (a fibrous membrane covering the sclera), and severing the optic nerve from the eyeball.
Evisceration: Removing the contents of the eye through an incision in the cornea or sclera, while leaving the optic nerve, sclera, and extraocular muscles intact. The primary advantage of this method over enucleation is the preservation of muscles and some eye structures, allowing better movement of the prosthesis after implantation. However, a significant disadvantage is the potential risk of blindness, inflammation, and severe vision loss in the remaining eye.
Exenteration: The removal of the eyelids, eye, and its contents. This procedure is performed in cases of malignant orbital tumors that threaten the patient’s life and do not respond to other treatments. In its most extensive form, exenteration includes the removal of orbital tissues and bones.

Ocular Prostheses (Artificial Eyes)

The use of implants and conformers (special prosthetic devices replacing the eyeball, usually made of silicone rubber) helps maintain the natural shape and structure of the eye socket, preventing a sunken or collapsed appearance.

After eye removal, a temporary conformer is placed in the eye socket to protect the surgical site, prevent contraction of the eye cavity, and prepare for the artificial eye while supporting eyelid integrity.

Once the ophthalmologist confirms that the eye socket has completely healed and is ready for the prosthetic eye (usually 6–8 weeks after surgery), the patient is referred to a specialist for an artificial eye fitting. All artificial eyes have some degree of movement limitation.

Types of Ocular Prostheses

Full ocular prostheses – Designed for patients who no longer have an eyeball.
Scleral shells – Similar in shape to full ocular prostheses but thinner, placed over a non-functioning but intact eyeball.

Post-Surgical Care for Eye Enucleation

The removed eye will have a large pressure dressing. Do not touch or wet the dressing. Consult your doctor about when to change it.
Avoid sleeping on the operated side.
Monitor for bleeding or discharge from the empty eye socket. If you notice any, contact your doctor.
Refrain from heavy physical activities.
Eat fresh fruits and vegetables to promote healing and prevent constipation (straining can increase pressure in the operated eye and risk bleeding).
Depth perception may be reduced after losing an eye; be cautious with movements to avoid misjudging heights and prevent falls.
Do not expose the operated eye to water. Consult your doctor about when you can bathe.
If the conformer falls out, place it in a sterile gauze and visit your ophthalmologist immediately.
Wear protective glasses to safeguard the healthy eye.

Wishing you a speedy recovery,
Farvardin Surgery Center