Having an Eye Removed.
Losing an eye can be to a lot of people an upsetting time, particularly for those who lose an eye unexpectedly. Whilst some persons may be relieved to end a period of having a painful poor sighted eye, others can experience a sense of grieving, as if they have lost a member of the family, or a close friend. This is not unusual at all, and is a stage that anyone may go through before they come to terms with their loss.
The prospect of having an eye removed is one that no-one ever takes lightly. It is a major decision taken by both doctor and patient and will likely have been taken after all other efforts have been made to try and save the eye.
There are chiefly three reasons for having an eye removed: injury, disease and abnormality equally there are three methods of removal:
- Enucleation – the removal of the whole eyeball,
- Evisceration – removing only the contents of the eyeball (currently the most common method),
- and Exenteration – the removal of the eyeball and surrounding tissues and even bone (this is rare and is usually associated with serious tumours).
Once the decision has been made to remove an eye it is very natural to have fears, and difficulties with coming to terms with all that is happening, but it may be some reassurance that very few patients suffer any long term problems – the most modern methods of surgery are used and the operation techniques are very advanced.
Some patients worry before having an eye removed “what if a mistake is made and the wrong eye is removed?” Patients can be re-assured – it won’t. The eye is identified by patient, nurse and doctor and is clearly marked. Other patients worry about pain during the operation. Again, patients should not worry about this as the eye is well aneasthetised. No pain at all is felt during the operation.
An Orbital Implant will most probably be inserted at the time of the surgery. This round ball – between 18-22mm in size – replaces volume inside the eye socket, allowing a thinner lighter artificial eye to be fitted. The extraocular muscles are attached to the implant, allowing it to move within the orbit like a natural eye. (When a patient is fitted with an artificial eye this movement is then transferred through the socket wall by friction – driving the eye and enhancing movement of the prosthesis to a noticeable degree.)
The surrounding tissue is then closed over the implant, and a pouch is formed behind the eyelids which will later hold the artificial eye. The whole operation takes on average about 45 minutes. It does not usually involve a long stay in hospital being on average between 2-4 days.
A smooth clear oval-shaped plastic shell called a Conformer may be inserted to be worn over the healing period – typically 6-8 weeks. This will help to preserve the shape of the socket, resist socket shrinkage, support the eyelids and will help the patient to acquaint themself with the idea of wearing something in their “new” socket. There may well be some bruising for a few days directly after removal of an eye, but this and any associated swelling will decrease.
Normally it will be about 6-8 weeks to the first appointment at the artificial eye clinic.
Initial difficulties may be experienced judging distances, but readjustment to this usually comes fairly soon. On the whole, people adjust well to having only one eye, and with the support and help of the specialists and friends and family, possibly sooner than they may at first believe.