Eye evisceration is a surgical procedure that involves the removal of the internal contents of the eyeball while leaving the sclera, or the white outer shell, intact. This procedure is most commonly performed in cases where the eye is severely damaged due to trauma, disease, or intractable pain that cannot be managed by other means. The goal of evisceration is to alleviate suffering while allowing for the preservation of the eye's exterior, which can support cosmetic rehabilitation with prosthetic devices. During the procedure, the surgeon makes an incision in the conjunctiva, the thin membrane covering the sclera, and carefully removes the contents of the eye-namely, the vitreous humor, retina, and choroid-using specialized instruments. This necessitates a deft touch and a deep understanding of ocular anatomy, as care must be taken to avoid damaging surrounding tissues. After the internal structures are removed, the scleral shell can be filled with a spacer material, which helps maintain the shape of the eye and provides a stable surface for an artificial eye (prosthesis) to be fitted later. One of the advantages of eye evisceration over enucleation, which involves the removal of the entire eyeball including the sclera, is that evisceration often results in a more natural appearance of the orbit following the procedure. Patients may experience a range of emotions and reactions upon learning that they require evisceration, as the implications for their vision, appearance, and psychological well-being can be significant. Post-operative care is crucial in ensuring the best possible healing and integration with any subsequent prosthetic fit. Patients are typically monitored for signs of infection and inflammation, as well as for overall comfort and satisfaction with the outcome. Following healing, the process of fitting a prosthetic eye begins, where an ocularist creates a custom artificial eye designed to match the shape and color of the remaining natural eye. This prosthetic can significantly enhance facial aesthetics and help restore a sense of normalcy for patients. While evisceration does not restore vision, it plays an essential role in improving quality of life by addressing painful conditions and enabling cosmetic interventions. Education and support from healthcare providers are paramount in helping patients navigate the emotional and physical changes that follow surgery. Ultimately, eye evisceration serves as a critical option in the management of debilitating ocular conditions, balancing the need for physical relief with the desire for cosmetic and emotional restoration. The decision to undergo this procedure is a significant one, often requiring careful consideration of all the factors involved, including the potential for psychological impact, the necessity for subsequent prosthetic fitting, and the overall goals of treatment.
