WHAT IS AN ENUCLEATION?
Enucleation is a surgery to remove an eye. There are two other ways to remove an eye, evisceration and exenteration. Evisceration removes the inside parts of the eye but keeps the outer white shell (sclera) and the muscles. Exenteration is the most thorough, removing the eye ball and nearby parts like soft tissues and eyelids.
WHEN IS AN ENUCLEATION NECESSARY?
Enucleation is a last resort surgery for when an eye is severely diseased or injured. Diseases like retinoblastoma or uveal melanoma and conditions that cause a blind, painful eye like end-stage glaucoma, chronic retinal detachment, severe infection or severe trauma might require enucleation. This surgery can relieve pain, lower risks to health and the other eye, and make the sick eye look more “natural” again.
Before enucleation, an ophthalmologist (eye doctor/surgeon) will do an exam to make sure it’s necessary and will explain all the risks and benefits. Since this procedure is a last resort, discussing all options is important.
WHAT IS AN OCULAR PROSTHESIS?
After an eye is removed with enucleation, an ocular prosthesis is used in its place. This prosthesis cannot restore vision but helps the eye and face look more natural and improves a person’s quality of life. During an enucleation, the muscles around the eye that move the eye are usually kept to help the prosthesis fit.
The prosthesis has two parts. First, a sphere/round ball (the orbital implant) sits in the eye socket where the eye used to be and is covered by eye socket tissues. It is usually made of plastic, calcium, metal, or glass. Second, there is a shell (ocular prosthesis) made by a specialist called an ocularist. This shell sits just behind the eyelids and in front of the orbital implant tissue and is the part of the ocular prosthesis that other people can see. Ocularists make the shell look as much like the other eye as possible. The shell can be removed and needs regular cleaning. Sometimes if the muscles around the eye and the shell are connected to the sphere (orbital implant), the prosthetic may move like the other eye does.