Of the two procedures, evisceration generally takes less time and is less invasive. However, not every patient is the right candidate for evisceration. With cancer, trauma (serious injury) and infection of the eye, enucleation is usually preferred over evisceration. In other cases, either procedure can generally achieve the same result.
A painful, blind eye before surgery. (Photo courtesy of Rona Silkiss, MD)
Talk with your ophthalmologist to determine which is the best surgery for you and whether there are any specific risks that you might need to consider when deciding which procedure to have.
It’s important to note that with either surgery, the results are not alterable and irreversible—there is no way to regain vision in that eye.
What to expect when you have eye removal surgery
Before the surgery. Tell your ophthalmologist about all the medicines you take. Your surgeon will tell you if you can keep taking them before surgery. Usually all medicines except blood thinners should be continued. The timing for discontinuation of a blood thinner is dependent on the type of blood thinner and its half life (metabolism of the drug in your system) as well as the health reasons you were placed on the medication.
When choosing a date for the surgery, keep in mind that strenuous physical activity and swimming are not advised for two weeks after surgery. It also may take up to two months of healing before you can be fitted for a prosthesis. The prosthesis is like a large contact lens, custom painted by the ocularist to resemble your other eye. It fits over the implant placed inside the eye during surgery. You should choose an ocularist and schedule an appointment with them before the surgery.
The day of your surgery
Here is what will happen just before and during eye removal surgery:
Both procedures take place in the operating room and you will be given either general anesthesia (numbing medicine and medicine that puts you to sleep) or local anesthesia with sedation (numbing medicine and medication that helps you relax).
As part of the eye surgery, a marble-like implant is placed inside the eye to fill the empty socket.
With enucleation, the six extraocular eye muscles are sewn to the implant. With evisceration, the muscles maintain their connection to the sclera so there is no need for surgery on them.
A temporary plastic prosthetic called a conformer is placed over the implant. The conformer aids healing and serves as a placeholder between the eyelids and the orbital implant, where the custom-painted final prosthetic will sit six to eight weeks later.
Sometimes, the eyelid is sewn shut to help the wound heal and hold the conformer in place.
Generally, both surgeries take about an hour. In most cases, the surgery is outpatient, meaning you can go home the same day.
Implants placed in the eye during eye removal surgery. (Photo courtesy of Rona Silkiss, MD)
The temporary contact lens–like prosthetic placed over the implant pictured above. (Photo courtesy of Rona Silkiss, MD)
Ride home. Arrange for a ride home from the hospital. You are not allowed to drive yourself home because driving yourself can be dangerous after receiving anesthesia. You also must be taken home by an adult other than a ride sharing service unless they have special qualifications.
Pain/medication. You may receive medication for pain, but over-the-counter pain relievers are enough for most patients. Prescription antibiotics or steroids may be needed in some cases.
Restrictions. Swimming, strenuous exercise or other demanding physical activities are restricted for two to four weeks. Bending at the waist and lifting heaving objects should also be avoided for up to a month. You may drive and perform other normal activities as soon as you feel well enough. Ask your surgeon for specific recommendations.
Take care to keep the bandage that is covering the eye dry. At times the bandage may feel itchy or uncomfortable, but it's important to keep it on as long as your surgeon says to. Generally, the bandage can be removed the next day.
Follow-up. The follow-up exam takes place about a week after the surgery. At this time, your surgeon may remove the bandage if you have not already done so, and look at your eye to see how it's healing.
Prosthetic. Once your surgeon finds your eye to be fully healed, you can be fitted for your custom prosthetic by your ocularist. Most patients are ready for their prosthetic six to eight weeks after surgery.
Your prosthesis can last decades if properly cleaned and maintained. You should have follow-up visits with your ocularist and surgeon one to two times per year. They will check the health of your eye socket and clean and polish your prosthetic. If you feel comfortable doing so, you can remove your prosthetic and clean it yourself between visits with your ocularist and surgeon.
Possible problems with eye removal surgery
Some problems resulting from eye removal surgery can include:
Talk with your surgeon to discuss the risks and benefits of surgery for you.
In general, eye removal surgery is performed to enhance a person's life. It is used to treat life threatening tumors or relieve patients of a blind, painful eye. The decision to remove an eye may be amongst the most difficult you need to make in your life. It is hoped, however, that the relief from pain and illness will be life enhancing and allow you to live your life fully and completely.
In certain cases where normal eye is bulging forward, or have pain in the eyes with out Vision, these patient may under go for evisceration or enucleation with or with out use of orbital implant. The surgical procedure to remove the entire natural eye is referred to as an enucleation where as the surgical procedure to remove the contents of of a natural eye is referred to as evisceration.Both procedures will need prosthetic restoration with the fitting of an artificial eye. This process can usually begin approximately six weeks following the initial surgery.
Fitting the artificial eye begins with a board certified ocularist taking an impression mold of the surgically repaired eye socket or residual eye. This procedure ensures each patient attains the maximum amount of comfort and movement possible.
Our team of board certified ocularists have developed advanced art and sculpting techniques to recreate artificial eyes with life-like and natural appearance. These techniques are focus on carefully matching eyelid contours, eyelid folds, and other features involved in achieving facial symmetry. We make every effort to maximize the amount of movement and to recreate an exact color match to your natural eye.
At International Prosthetic Eye Center, we utilize a combination of digital photography and hand painted technques to replicate the color and details of your eye. Only natural earth pigments are used in the painting of our artificial eyes. These pigments provide exquisite detail, depth of color, and vibrancy for the life of your artificial eye.
Team is highly qualified and very passionated to care for you at every step of providing care.
Kuldeep Raizada, Ph D BCO, BADO, FAAO
Kuldeep Raizada is a Licensed Ocularist in Hyderabad, a Board Certified Ocularist (BCO) from National examination Board of ocularist’s, USA and a Board Approved Diplomate Ocularist (BADO) from American Society of ocularist’s, specializing in ocular prosthetics since 2001, Kuldeep places his emphasis on the satisfaction and well-being of every patient. His clinical skill and expertise are equally matched by his personalized care for patients and attention to detail.
Kuldeep Raizada completed his basic optometry education at Gandhi Eye Hospital, Aligarh, and has his training at L V Prasad Eye Institute, Hyderabad. where he was also Founder and Head of the Department of Ocular Prosthesis services till 2009. He completed a second fellowship, in Anaplastolgy, at MD Anderson Cancer Centre, Houston. He has also been trained by the top most ocularist and anaplastologist in United States of America.
His clinical interests include ocular and facial prosthesis, particularly in pediatric patients. His research interests lie in newer advancement in development of new types of prosthesis, newer solution for ptosis corrective glasses.
Kuldeep Raizada, is Founder & Director of the International Prosthetic Eye Center since 2010, where he is practicing since 2010.
Kuldeep Raizada has been recognized by the American Society of Ocularist, USA and American Anaplastology Association,USA and by several other professional organizations, for his excellence in research and clinical practice.
Kuldeep Raizada, have completed all requirements by American Society of Ocularist, which is hard work of 14000 working hours as well extensive study for prosthetics, Hence awarded theDiplomate Ocularist from American Society of Ocularist, USA, 2012, Chicago, USA, which is the First ever received all over Asia Pacific & throughout Middle East so ever.
At present he is reviewer of several journals like Contact Lens & Anterior Eye, International Journal of Anaplastology, Oculoplasty & Reconstructive Surgery (OPRS) and Many others. He has published and presented world widely.
Fact About Kuldeep
CEO & Chairman of Akriti
Founder & Director International Prosthetic Eye Center, India
Founder of Healthcare India Magazine
Receipt of Abdul Kalam Award.
First ever Indian to received Board Certifications, from National Board of examination of ocularist, USA, He was the first One all over Asia Pacific & throughout Middle East.
Developed First Digital Dynamic Facial Eye Prosthesis
Developed physiological Near Stereo test
Developed physiological Distance Stereo test
Developed ETDRS Log Mar Vision Charts in Hindi for 4 Meters
Developed ETDRS Log Mar Vision Charts in Telegu for 4 Meters
Developed ETDRS Log Mar Vision Charts in Assamese for 4 Meters
Developed ETDRS Log Mar Vision Charts in Arabic for 4 Meters
Developed ETDRS Log Mar Vision Charts in Bangla for 4 Meters
Developed ETDRS Log Mar Vision Charts in Tamil for 4 Meters
Developed ETDRS Log Mar Vision Charts in Oriya for 4 Meters
Developed ETDRS Log Mar Vision Charts in Kannada for 4 Meters
Developed ETDRS Log Mar Vision Charts in Malayalam for 4 Meters
Deepa D Raizada, MS, BCA, BCO, BCCA
Deepa completed her diploma and clinical fellowship in optometry at L V Prasad Eye Institute, India, in 2003, pursued her graduation from Madhurai Kamraj University, 2006.
She had completed her Master of Science (M Sc) in “Maxillofacial and Craniofacial Technology” (2010-2012), King’s Collage London, UK where she was trained to work exclusively in the field of Maxillofacial Prosthetics.
Deepa is also an associate Member of The Institute of Maxillofacial Prosthetist & Technologist, UK (AIMPT) since 2014. & Active Member of International Anaplastology Association, (IAA) USA since 2009.
Deepa Have make a remarkable success in becoming "Asia's First Board Certified Clinical Anaplastologist ( BCCA") and Bring glory for India as to Make India Fifth Nation to have a Board Certified Clinical Anaplastologist.
She Did complete her Board Certification for Ocularist (BCO), By National Examination Board of ocularist, USA in March 2018
She persued her basic training in Ocularistry from L V Prasad Eye Institute, Hyderabad and advanced training in Ocular Prosthetics (May – July, 2005) at Moorefield’s Eye Hospital, London, UK under Mr Nigel Saap.
She worked as an Ocularist at Ocular Prosthesis Department, L V Prasad Eye Institute from 2003 – 2010. She worked with different type of techniques, developed new techniques in the fabrication and fitting of ocular & facial Prostheses. Her work was well recognized and appreciated.
Her clinical interest include make her career in the art and science of facial prosthetics and ocular prosthetics, particularly in pediatric patients. Her research interests lie in developing new techniques in the field of facial prosthetics, and undertake research on materials used in this field.
Deepa Raizada has been recognized by the Oculoplasty Society of India, Indian Optometric Association and by several other professional organizations in India as well as Internationally, for her excellence in research and clinical practice.