This information is for patients who are to undergo an operation to remove the eye called enucleation.
Why do I need an enucleation?
This operation is sometimes necessary to treat eye cancer. It is only undertaken if all other treatment options are ineffective. Your doctor will have discussed the treatment options with you and explained that this is the best treatment for you. The aim of the operation is to remove your tumour.
What is enucleation?
An enucleation operation is where the eye ball is removed. The eyelids, eyelashes, appearance. After surgery, a temporary transparent plastic shell is put in place in the eye socket to allow healing and give shape.
After a few weeks the clear shell will be replaced by an artificial eye (prosthesis). The prosthesis is shaped like a large contact lens and will sit in your eye socket over the orbital implant. You will be shown how to remove it so that you can clean it when required.
What are the complications of an enucleation operation?
The operation is usually straightforward but as with all surgery there is a small risk of complications. Short-term complications can include bleeding, swelling and infection. Long-term complications can include discharge and socket irritation or exposure of the ball implant.
What happens before the operation?
You will be given a general anaesthetic for this operation and you will be admitted to the hospital or the hostel one day before the operation so that you can have various blood tests and routine tests such as a chest x-ray and scans. Your socket heals and a temporary artificial eye is able to be fitted.
The nursing staff will show you how to clean your eye socket and give you some information on taking care of your eye and the shell. When you go home it is best to keep your eye uncovered to help healing but you can wear dark glasses until the swelling goes down.
Very occasionally the shell may fall out. This rarely happens but if it does, follow the cleaning and care instructions the nursing staff give you after the operation.
How will I feel after the operation?
You may feel upset after having your eye removed, especially if you had some sight in your eye before the operation. Your emotions may fluctuate as you realise you are losing, or have lost, a part of you. You may also feel grief, sadness, bitterness and anger, and initially find it difficult to come to terms with having only one eye. Some patients have the sensation that the eye is still there or have temporary visual hallucinations or flashing lights. This is all quite normal and will improve over time.
The process of making a prosthesis takes about a month and you will be fitted with a temporary prosthesis until your permanent one is ready.
Once fitted your artificial eye will have should be an adequate range of eye movement.
You will be able to sleep with it in place and once the socket is completely healed you can continue with your normal life. Eye make-up can be worn and you can swim or do other water sports (you are advised to wear goggles to avoid loss of the artificial eye).
You are also advised to wear eye protection when doing any activity that could cause eye injury (eg DIY).
What will happen after the operation?
You will go back to the ward after surgery and your eye will be covered with a firm dressing to help reduce swelling. This will stay in place for about one day.
Your eye may feel a little painful and sore, and you will be given pain killers if you need them.
The day after the operation the dressing will be removed. Your eye socket will look red but it will become pinker in colour as it heals. Some bruising and swelling of the eyelids may occur; this can become worse over the first few days before gradually getting better.
You will be able to see the clear plastic shell that has been placed in your eye socket. This has a hole in the middle to help with airflow and drainage. It is easily removed but should stay in place until
If you would like to talk to someone about coping after having an enucleation you can contact one of several helpful organisations. You can also talk to one of our ocular oncology clinical nurse specialists. (contact details are at the end of this leaflet).