Enucleation
WHAT IS AN ENUCLEATION?
Enucleation is surgery to remove the whole eye.
There are two other surgeries that also remove parts of the eye:
- Evisceration – removes the inside parts of the eye but leaves the outer white part (the sclera) and the eye muscles.
- Exenteration – removes the eyeball plus nearby parts, such as soft tissue and eyelids.
WHEN IS AN ENUCLEATION NECESSARY?
Enucleation is only done as a last choice when the eye is badly diseased or injured.
It may be needed for:
- Eye cancers such as retinoblastoma or uveal melanoma
- A blind, painful eye from conditions like advanced glaucoma, long-term retinal detachment, severe infection, or major injury
This surgery can:
- Stop pain
- Lower risks to the rest of the body and the other eye
- Make a damaged eye look better
Before surgery, an eye doctor (ophthalmologist) will check the eye. The eye doctor will explain risks and benefits, and talk through all possible choices.
WHAT IS AN OCULAR PROSTHESIS?
After the eye is removed, an ocular prosthesis (false/fake eye) is placed in the socket. This false eye cannot make the eye see. But it can make the eye area and face look more normal. It can also help people feel better about how they look.
During surgery, the eye muscles are usually kept. This helps the false eye to fit and move better.
The prosthesis (false/fake eye) has two main parts:
- Orbital implant (sphere/ball): A round ball placed in the eye socket where the eye used to be. It is covered by tissue. The ball is usually made of plastic, a material with calcium, metal, or glass.
- Ocular prosthesis (shell): A thin shell made by a specialist called an ocularist. This shell fits over the ball covered by tissue and behind the eyelids. It the part of the false eye that you can see. It is made to look as much like the other eye as possible.
The shell can be taken out for cleaning and needs regular care. Sometimes, if the muscles and the shell are attached to the ball, the false eye may move along with the natural eye.
Summary for patients and caregivers
Enucleation is surgery to remove the entire eye. It is usually done only when there is very bad eye disease, injury, or cancer. A prosthesis (false/fake eye) does not see. But it can help with comfort, looks, and how someone feels about themself. The prosthesis or false eye has two parts: an inner ball and an outer shell. The shell is made to look like the natural eye. With care and regular cleaning, most people adjust well and can have a natural look again.
Updated 09/2025
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