Enucleation & Evisceration
Enucleation & Evisceration
What are enucleation & evisceration?
Enucleation and evisceration are terms that refer to surgery to remove the eye from the eye socket or orbit.
- Enucleation is the surgical removal of the entire eyeball leaving behind the lining of the eyelids and muscles of the eye.
- Evisceration removes only the contents of the eye, leaving the white part of the eye (the sclera) and the eye muscles intact.
Enucleation is generally the procedure used if the eye is being removed to treat an intraocular tumor, severe infection, or to reduce the risk of developing a severe autoimmune condition (called sympathetic ophthalmia) following trauma to the eye.
Evisceration is a less invasive procedure and may be an option depending on the condition of the eye to be operated on. Your surgeon will advise which surgery is most appropriate for you.
Why is enucleation or evisceration necessary?
Removal of an eye may be required following a severe injury, to remove an intra-ocular tumor (tumors inside the eye), to control pain in a blind eye, to alleviate a severe infection inside the eye, or for cosmetic improvement of a disfigured eye.
Appointment Information
For more information or to make an appointment, call 734-764-4190.
What can I expect during and after enucleation or evisceration surgery?
Both surgeries are performed in the operating room, typically under general anesthesia, though they can also be safely done using local anesthesia with sedation. While both types of anesthesia are generally well-tolerated, some side effects, such as nausea or vomiting, may occur.
During the procedure, a marble-sized implant is placed behind the conjunctiva tissue in your eye socket to replace lost volume after your eye is removed. These implants are made from materials like silicone, plastic, or porous options such as Medpor (porous polyethylene), hydroxyapatite, or bioceramic. In some cases, the implant may be connected to your eye muscles, which allows it—and your future artificial eye—to move naturally.
At the end of the surgery, a thin plastic shell called a conformer is placed in the socket to help maintain its shape and reduce swelling. You’ll receive a local anesthetic injection during the procedure, which typically keeps you comfortable for several hours afterward. If you experience any discomfort after that, painkillers are usually very effective in managing it.
The surgery itself takes about one to two hours, and a pressure bandage is often applied to help minimize swelling. Once healed, your eye socket will resemble the texture of the skin on the inside of your lip. Your tear function will remain unaffected, and when your artificial eye is fitted, you’ll be able to open and close your eyelids just as you did before.
Rest assured, the goal is to help you feel comfortable and confident throughout the process and beyond.
Before your surgery, your doctor will talk through your surgery with you. On the day of your surgery, you should check in on the 4th floor of the Kellogg Eye Center.
For children, the surgery will take place at C.S Mott Children’s Hospital.
On the day of surgery please bring with you:
- Any medications you are taking in their original container
- Personal items you may need such as toiletries
- Name and phone number of primary care physician
- Name and phone number of cardiologist, if applicable
- You will wake up in the recovery room and have a pressure bandage or pad over your operated eye. After you wake up you will be taken to the Outpatient Surgery Unit.
- You will go home the same day as your surgery.
- Your eye socket will be red and possibly swollen for a couple of weeks.
- You may see colors and other images from the side of the operation (i.e., ‘phantom eye’). This symptom resolves spontaneously.
- The pressure pad will remain on for 6 to 14 days.
- When the pad is removed, eye drops and/or ointment will be used in the socket to aid healing. This continues at home. For some patients, eye drops can be challenging so you may need someone to help you. Make sure you wash your hands before and after using drops.
- For the first 2 to 3 days after surgery, you should rest. Movement of your remaining eye will also cause the implant to move, which can cause pain. Avoid bending over, as this can cause pressure in the socket and can be painful.
- Your doctor will prescribe a pain reliever and anti-nausea medication.
- A patch is usually worn over the eye socket until the artificial eye is made.
- You will have a follow-up appointment with your doctor about 4 to 6 weeks after your procedure. This will help detect any complications that require further treatment.
- After surgery you will be fitted for an artificial eye, known as a prosthesis.
What Is Life Like After Enucleation Surgery?
In this video, Matthew shares his lifelong journey with enucleation (the removal of an eye) and his experience living with a prosthetic eye. He provides personal insights into the surgical process, the fitting of prosthetics, and how he has adapted his lifestyle over the years.
Patient Resources
FAQs
There may be other treatments available and your doctor will have discussed these with you. If you feel that you need further information, please ask your doctor.
There can be a number of different outcomes if you choose not to have your eye removed. An intraocular tumor may continue to grow or spread to other parts of the body making treatment more difficult. An infected eye may become worse and the infection may spread making treatment and pain management more difficult.
- A small amount of discharge may occur and accumulate in the inner corner. Larger amounts accumulating or running onto the cheek could be a sign of infection and you should contact your doctor.
- To clean away discharge, use saline solution and a clean cotton ball. Wipe from the outer corner of the eye (near the ear) towards the nose.
- Use each cotton ball only once and then discard it.
- Saline solution can be purchased from a pharmacy.
Locations
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Oculoplastic Surgery Clinic | Kellogg Eye Center 1000 Wall St
Elevator B Floor 3
Ann Arbor, MI 48105-1912Get Directions
Doctors
Hakan Demirci, MD
Professor
Ophthalmology
Elaine Downie, MD
Clinical Assistant Professor
Ophthalmology, Oculoplastics Ophthalmology
Victor Maurice Elner, MD, PhD
Professor
Ophthalmology, Anatomic Pathology
Denise Sujin Kim, MD
Clinical Assistant Professor
Ophthalmology
Christine Carol Nelson, MD, FACS
Professor
Ophthalmology
Brittany A Simmons, MD
Clinical Assistant Professor
Ophthalmology
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