Evisceration and Enucleation

Many disorders of the eye are treatable with modern medicine and continued monitored care by a physician.  Unfortunately, despite the best attempt of patients and physicians alike, ocular disorders and or trauma can lead to loss of vision in one or both eyes.  Loss of vision does not always result in the loss of an eye, however, if vision loss is accompanied by pain or resulting in a phenomena known as sympathetic ophthalmia, it may benefit a patient to have a blind/ non-functioning eye removed.  

Eye removal is not ideal for many people, however, in some cases it may benefit a patient to have the eye removed and replace with an ocular implant. Eye removal can be done one of two ways, depending on anatomical structures connected to and around the eye, and the eye itself.

1. Evisceration: An evisceration is a surgical procedure by which the physician will remove the inner contents of the eye, while maintaining the sclera (white part of the eye), conjunctiva, and the muscles attached to the eye itself.  Once the inner contents of the eye are removed, a hydroxyapatite implant is inserted in the scleral, and the original conjunctiva of the patient is closed over the implant.  An evisceration, if performed, provides patients the ability to be fitted with an ocular prosthesis that has range of motion, since muscular structures attached to the eye are not usually stripped or cut.  Once the eye has healed from surgery, patients can make an appointment with an ocularist to be custom fit for a prosthesis which is made to try and match the new prosthetic with the appearance of the functioning eye.  With an evisceration, there is no guarantee that both eyes will have equal range of motion, although the intent is to provide patients the opportunity to limit social interferences which may be accompanied by an ocular implant. 

2. Enucleation: An enucleation is a surgical procedure by which the physician will remove the entire eye from the orbit.  In this procedure, the physician will detach the muscle connecting the eye to the orbit, and disconnect the eye from the optic nerve.  Once the muscles and nerve have been detached, the physician will remove the entire eye from the orbit, and replace the eye with a hydroxyapatite implant. In the best of scenarios, the physician may be able to attach the original muscles surrounding the eye to the new implant, followed by covering the implant with the original conjunctiva of the patient. The intent of reattaching ocular muscles is to provide the patient with some mobility of the ocular prosthetic. Once healing as completed, a patient can schedule to meet with an Ocularist, who can fit the patient for a prosthesis matching the appearance of the other eye.  

Transitioning to life with vision loss, or following sudden loss of vision may be difficult for many people. Speak to our staff to learn about resources available for patients regarding lifestyle adjustments

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