What Patients Should Know Before Undergoing Enucleation

Health & Medical Blog

Vision loss is among the top 10 disabilities in the United States, with an estimated 3 percent of Americans reporting legal blindness or other visual acuity problems. But while vision loss is common enough that just about everyone knows someone affected by it, certain conditions that require enucleation—the surgical removal of the eye itself—are far rarer. Read on to learn more about the enucleation process, your prosthetic options, and some questions you'll want to ask before undergoing this procedure.

When is enucleation recommended as a treatment option?

Blindness generally doesn't impact the underlying health of the eye. A blind eye may be able to move, lubricate itself, and otherwise function just as a seeing eye—just without the ability to send signals to your brain to translate into images.

But in some cases, the condition that caused blindness poses additional risks to the eye (or the rest of your body) if the eye is left in place. Doctors may recommend enucleation as a way to prevent eye cancer from spreading or an infection from robbing a patient of the vision in their remaining "good" eye. And some blind individuals may opt for enucleation as a way to achieve a more aesthetically pleasing look if the blind eye has a milky appearance or is visibly damaged. 

In other cases, an eye injury or ailment that doesn't cause blindness may still require enucleation. Because of the eye's close proximity to the brain, a chronic or uncontrolled eye infection or disease may increase one's risk of developing meningitis, a glioma or other brain tumor, or other potentially fatal conditions. In these situations, losing one's vision by having the eye surgically removed may be the best of a series of less-than-ideal options.  

What are your prosthetic options?

Fortunately, enucleation doesn't need to leave you with an empty eye socket or a permanent pirate-like patch. Prosthetics have advanced so that the casual viewer will never even guess that one of your eyes is an artificial one.

Having a prosthetic eye placed is usually a two-step process. First, a placeholder is fitted into the eye immediately after the enucleation surgery. This helps the eyelid and surrounding tissue retain their shape so that the prosthetic will fit neatly.

Next, after swelling has subsided and the interior of the eye has begun to heal, you'll visit an ocularist at a place like Real Life Faces to be fitted for a glass or other artificial eye. The ocularist will take measurements of the ocular cavity and photos of your good eye to assist in developing a prosthesis that matches perfectly. You'll usually need to have this eye examined at least annually, and may require refittings or new prostheses as the dimensions of your ocular cavity change with time.  

What questions should you ask your doctor before proceeding?

Before you commit to enucleation, there are a few questions you'll want to have answered by your surgeon or ophthalmologist.

First is the need for enucleation. Your doctor has likely already explained to you why enucleation has been suggested, but having a clear answer for why enucleation is the best of your options can give you the confidence you need to make a potentially life-altering decision. For example, knowing that keeping your bad eye for more than a year carries with it a 70 or 80 percent risk that you'll lose vision in your good eye can make this choice far easier; and hearing that the risk of vision loss is only 10 to 20 percent may prompt you to take a "watchful waiting" approach instead.

You'll also want to find out more about your expected recovery time, especially as it relates to the timing of your prosthetic placement. Rushing into a prosthesis could complicate healing, so giving yourself plenty of time and sticking carefully to your aftercare plan gives you the best opportunity for success.


25 July 2018

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