Evisceration (ophthalmology)
| Evisceration | |
|---|---|
| MeSH | D017234 |
An evisceration is the removal of the eye's contents, leaving the scleral shell and extraocular muscles intact.[1][2] The procedure is usually performed to reduce pain or improve cosmesis in a blind eye, as in cases of endophthalmitis unresponsive to antibiotics.[1][2] An ocular prosthetic can be fitted over the eviscerated eye in order to improve cosmesis.[3]
Either general or local anesthetics may be used during eviscerations, with antibiotics and anti-inflammatory agents injected intravenously.[4]
Background
Evisceration is a surgical procedure that involves the removal of all the eye’s contents while leaving the white part of the eye (scleral shell) and extraocular muscles in place.[5] Evisceration differs from enucleation, as enucleation removes the entire globe. This includes the scleral shell, and extraocular muscles are resewn onto an artificial eye to allow for eye motion. The surgery was first described by Bear in 1817 as an experimental treatment for expulsive hemorrhage, and with the advent of general anesthesia in the 1840’s the procedure was refined and ocular implants were developed.
Indications
Evisceration involves disrupting the integrity of the globe, and therefore is not typically used in patients with intraocular malignancy as it may risk spreading cancerous cells to other parts of the body. The most common indications for evisceration include a blind painful eye, trauma, or infection.
Surgical Technique
The surgery is performed in the operating room typically under general anesthesia, however it can also be conducted using local anesthesia with sedation. Procedure time is typically one to two hours.
Post-Operation
After the surgery, strenuous physical activity should be avoided until cleared by a physician. Contaminated bodies of water, such as pools, lakes, and the ocean should be avoided. The surgeon will typically provide instructions on bathing, as tap water may also be contaminated.
Post-operative pain may be controlled with either prescription medications or over the counter pain relievers. Some patients may be given steroids or antibiotics depending on the indication for the surgery and surgeon preference.
Prostheses
Once the operating surgeon determines that the orbit has healed adequately, an ocularist can custom fit a prosthetic eye to improve cosmetic appearance. This will typically occur 6-8 weeks post-op. With proper care, prosthetic eyes can last decades.
See also
[edit]References
[edit]- ^ a b Cassin, B. and Solomon, S. Dictionary of Eye Terminology. Gainesville, Florida: Triad Publishing Company, 1990.
- ^ a b Zein W. "Evisceration, Enucleation, and Exenteration." Archived 2006-09-26 at the Wayback Machine Eyeweb.org. Accessed September 25, 2006.
- ^ "Evisceration". Archived 2016-03-03 at the Wayback Machine Ocularist Association of California. Accessed September 25, 2006.
- ^ "Surgical Technique: Evisceration". Archived 2016-06-10 at the Wayback Machine Bio-Eye Orbital Implants. Accessed September 25, 2006.
- ^ PICK, ALBERT (1898-01-08). "AN EXPERIMENT ON A RABBIT'S EYE, TO OBTAIN AN ELASTIC, UNBREAKABLE "ARTIFICIAL VITREOUS BODY" AFTER EVISCERATION". Journal of the American Medical Association. XXX (2): 66. doi:10.1001/jama.1898.72440540014002d. ISSN 0002-9955.