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Enucleation

DESCRIPTION: The surgical removal of the eyeball from its orbit. Indications for removal include:

  • When trauma is so extensive that the form of the eyeball cannot be preserved;
  • Prevention or treatment of sympathetic ophthalmitis;
  • Severe pain in a blind eye;
  • Iridocyclitis, phthisis bulbi, and glaucoma when accompanied by severe pain or inflammatory symptoms;
  • Malignant tumors;
  • Anterior staphyloma, if the eye is blind, troublesome and disfiguring;
  • Early panophthalmitis;
  • Intraocular foreign bodies which cannot be removed and which cause irritation;
  • Cosmetic improvement in blind and disfigured eyes;
  • Unilateral retinoblastoma.

TREATMENT: Artificial eyes are worn after enucleation, for cosmetic purposes and to fill the cavity left between the eyelids. In addition, a prosthesis prevents the eye lashes from turning in and irritating the conjunctiva. A prosthesis can be worn as soon as the socket is free from inflammation (about 1 month). It is usually made of plastic material, which is more expensive than glass, but is unbreakable and needs replacement less often. A prosthesis should be cleaned often.

IMPLICATIONS: If only one eye has been removed (and the other eye has normal visual function), the only impairment in visual abilities will be lack of depth perception. A protective lens for the good eye may be indicated; Orientation & Mobility instruction may also be needed, to orient to the loss of the 90° periphery.

If both eyes have been removed (or if the remaining eye is impaired), adaptive measures will be needed. These could include training in communication skills and daily living skills, Orientation and Mobility instruction, and vocational guidance. Since extreme changes in visual functioning involve elements of emotional reactions, psychological counseling may also be indicated.

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