Eyes that have sustained severe injuries or multiple previous surgeries become phthisical; that is they shrink in size and become increasingly painful.

The eye removal is indicated for cosmetic reasons but also to relieve the constant ache.

There are two techniques used to remove an eyeball; the evisceration and the enucleation. Evisceration involves removal of the eyeball contents leaving the surrounding scleral tissue intact, whereas enucleation is a more extensive procedure that involves complete removal of the eye and not just its content. Both procedures are performed under general anesthesia. Evisceration is faster and simpler procedure giving better aesthetic results and also leads to better ocular motility. Enucleation is reserved nowadays only for cases of intraocular tumors, for example melanoma.

Both procedures involve implantation of an acrylic ball that replaces the volume of the eye. The tissues are sutured over the implant and a temporary prosthesis is placed until a permanent one is fitted usually two to three months following surgery.

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Penetrating corneal ulcer with iris prolapse, significant eye pain and phthisis in the left eye
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One week following left eye evisceration
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Excellent cosmesis following fitting of the permanent prosthesis