There are few occasions when removing all or part of the eyeball and/or eye socket is necessary. This type of surgery is a last resort for a number of disorders, such as when a traumatic eye is irreparable; a blind, painful eye is refractory to medication; or there is cancer within the eye or extending beyond the eye into the orbit.

There are three surgical techniques for partial or complete eye removal.

Evisceration – Evisceration involves removing the eye contents, while leaving the sclera (the white part of the eye) in place and the muscles responsible for the eye movements intact. A spherical implant will be placed within the sclera to replace volume that has been removed. Evisceration is the least traumatic procedure for the eye socket and usually yields the best cosmetic result.
Enucleation – Enucleation involves the removal of the entire eye, including the sclera. The muscles are not removed and are attached to a spherical implant.
Exenteration – Exenteration is the most radical of the three procedures. It involves removing the entire eye, eye muscles, most of the orbital soft tissues and occasionally part of the orbital bones. This procedure is reserved for severe cancers or life-threatening infections.

The surgeon will determine which is the absolutely necessary procedure.

What to expect after surgery
A pressure patch will be placed over the removed eye the first 72 hours. Once the patch is removed, patient will start antibiotic drop three times daily and ointment at bedtime. After 4-6 weeks of healing, the socket may be ready for a prosthesis. The prosthesis is customized by an ocularist to mirror the fellow eye, allowing for optimal cosmetic result. In some cases, reconstructive procedures may be required to increase volume of the orbit or enhance the socket at a much later time. Patients should be seen by their oculoplastic surgeon once a year and the ocularist 1 to 2 times a year for maintenance of the socket and prosthesis, respectively.