Eye Removal
The decision to remove an eye is a major
one & is usually taken when it is not possible to salvage the eye.
The decision to remove the eye is
usually taken due to a number of reasons:
-
To alleviate pain and discomfort in
a blind eye.
-
To remove a malignant tumour even if
the eye enjoys perfect eyesight.
-
Blind or unsalvageable eyes
following severe trauma or chronic disease (e.g. corneal perforation ,
infections etc)
-
To remove painless unsightly blind
eyes for aesthetic reasons.
-
To prevent Sympathetic Ophthalmia of
the unaffected eye in cases of penetrating eye trauma.
Enucleation: is the removal of
the eye ball as a whole.
Evisceration: is the removal of
the contents of the eye ball leaving the outer layers intact (the white layer is
the sclera and the outer covering is called the conjunctiva).
In most cases a ball orbital implant is
used to replace the volume in the socket and the sclera and conjunctiva are used
to cover the implant.
A transparent conformer is placed into
the socket at the time of surgery. This helps to maintain the shape & space of
the socket while it heals and the patient awaits their artificial eye.
The patient usually needs to allow
approximately 6 weeks for the socket to heal. The patient usually receives an
appointment from the ocular prosthetist (artificial eye fitter) between 6 to 8
weeks of having surgery. A stock (temporary) artificial eye is initially
dispensed. A further appointment is then made to take an impression of the
socket to make a customised artificial eye for the patient.
Diagram of Eye Socket and implant.
Orbital Implants
There is a choice of materials and sizes
of orbital implants. Orbital implants could be made of non integrateable
materials like Acrylic or Glass or integrateable materials like Hydroxyapatite
(coral) or Medpor (synthetic coral).
The Day of surgery
The operation is usually performed under
a general anaesthetic and takes about one and a half to two hours. To help to
maintain the shape and space of the socket a clear shell (conformer) with a hole
in the front is inserted at the time of surgery. The hole in the conformer
allows the patient to administer ointment or drops to the socket.
Postoperatively a firm eye pad is placed
to help reduce swelling and this is usually left in place until you are seen in
clinic in 3-4 days. The eyelids may be bruised and swollen initially and with
some discharge lasting a few days. Most patients are able to go home the day
after surgery.
After Care
Any discharge on the eye lid can be
gently wiped off gently with cotton wool soaked in cooled boiled water. If there
is excessive discharge or it is discoloured please contact your surgeon or
attend the walk in eye casualty at the University Hospital Coventry.
Once the swelling has reduced and the
socket has settled down you will have an appointment with the artificial eye
fitter.
Many people are concerned about how they
will look after the surgery. The socket looks pink (much like the inside of your
mouth) which is occupied by the artificial eye. Once the artificial eye is
fitted it should provide a reasonable match to your other eye. The only time you
need to remove the implant is for cleaning or if you suspect you have an
infection (pain, redness of the socket and yellow-green sticky discharge).
You will need time to adjust to vision
with one eye (especially if the eye removed was not blind). You might find it
difficult to judge distances and depth initially.
Returning to work depends on how
confident you feel afterwards and the type of job you do.
I hope you found this information useful
and should you have any further query’s please contact
Mr Harpreet Ahluwalia
02476966506
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