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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:
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.
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.
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