Enucleation (Eye Removal)

The need for eye removal has been documented in the oldest written “Code of Hammurabi” of Babylon (1958-1916 B.C.) Since that time, the concepts of when and how to remove eyes have undergone a significant evolution. However, the goals have always remained the same; to remove the offending eye, protect the remaining eye, provide facial symmetry and allow movement of the ocular prosthesis (false eye).

Eye removal may be necessary due to ocular pain, glaucoma, trauma, globe shrinkage, infections, inflammation or tumors. There are two types of eye removal; enucleation where the entire eye is removed and evisceration where the inner contents are removed leaving the “white” of the eye intact. The main advantage of enucleation is to completely remove the eye contents, particularly when tumor is a consideration. The advantage of evisceration is to preserve movement since the eye muscles remain at their natural attachments to the sclera (white of the eye.) In addition, evisceration allows a more normal anterior position of the implant.

When an eye is removed, the volume of the globe must be replaced or the remaining socket will appear “sunken.” A spherical implant is typically buried in the socket. the appearance of a normal eye is created by the false eye, which is worn behind the eyelids like a large contact lens, to fill the remaining volume. For more information about ocular prosthetics see the following websites:

American Society of Ocularists
Eye Concern