Losing an eye is a life-changing experience. Trauma, tumors, infection, and advanced eye diseases can all result in the loss of an eye. Though there is no way to restore vision in this instance, with the proper surgical care a more normal cosmetic appearance can be obtained with an ocular prosthesis after removal of the eye.
There are primarily two surgeries that accomplish the removal of a damaged or diseased eye and allow for wearing an ocular prosthesis.
An enucleation is a procedure in which the entire eye is removed and a plastic implant is inserted into the eye socket. The eye muscles and conjunctiva are preserved, and the muscles are attached to the implant for motility of the prosthesis to be made later. The conjunctiva is then closed over the implant so the immediate surgical appearance is of that of the inside surface of the eyelid or lip. A plastic contact lens is then placed into the space under the eyelids to keep this space from scarring closed.
An evisceration is a very similar procedure with a similar result. The only difference is that, in an evisceration, the shell of the eye is preserved, and an implant is placed within this shell. Postoperative appearance and movement is very similar.
Depending on the situation, one procedure may be more appropriate than the other, and our oculoplastic surgeon will discuss these options with you before making a recommendation.
At the time of surgery, an implant is placed deep in the eye socket to fill the space left after removal of an eye. Typically, this implant is made of porous plastic though, there are some situations in which another material may be used. This implant should never be visible externally.
Six to eight weeks after surgery, the eye socket will have healed and an ocular prosthesis may be worn. An “ocularist” creates, molds and paints the prosthetic to match the other eye. This work is usually accomplished in 1-3 visits. Since the eye muscles were attached to the orbital implant at the time of surgery, the ocular prosthesis typically moves relatively well with the other eye.
Routine care and follow up is needed after the fitting of an ocular prosthesis. Care and maintenance of the prosthetic is infrequent and will be explained by your ocularist. Your oculoplastic surgeon or ophthalmologist will need to examine the eye socket at least once yearly.