Anophthalmos/Prosthetic Eye/Socket Reconstruction
Anophthalmos is the medical term used to describe when an eye has been removed. Eye removal surgery (enucleation and evisceration) is performed for a few different reasons. First, there may be a tumor that requires the entire eye to be removed. Second, the eye may be damaged from trauma and is beyond repair. Third, the eye can become blind and painful or severely disfigured (a condition called phthysis) from chronic diseases such as glaucoma, diabetes, or other degenerative conditions. Fourth, the eye may need to be removed if there is an overwhelming infection (such as severe endophthalmitis). Rarely, a patient can be born with a blind, small, or disfigured eye that can benefit from removal.
Evisceration and enucleation are two different eye removal procedures. There are advantages and disadvantages to each.
Evisceration involves removing the contents of the eye and placing an implant inside the tough, white, sclera, which acts like the “shell” of the eye. Evisceration is usually performed for blind, painful, or disfigured eyes. It is not performed when a tumor is present. Since the eye muscles and orbit is not disturbed, there is some thought that evisceration may have a higher chance of a better cosmetic result.
Enucleation involves detaching the eye muscles and removing the entire eye. An implant is then placed in the socket and the eye muscles are reattached to the implant. Enucleation is the procedure of choice when there is a tumor in the eye, but can be performed whenever eye removal is necessary.
Both procedures are usually performed as an outpatient and take about an hour. The operative site is typically patched for a week after surgery. A placeholder called a conformer is left in the socket until healing is complete. After swelling has subsided, the socket can be fit for a prosthetic eye.
The Prosthetic Eye
The prosthetic eye is custom made to match to other eye. Typically the cosmetic outcome is excellent and it often difficult to tell that the eye is a prosthetic. The prosthetic eye can move with the other eye because the implant within the socket (orbital implant) is attached the eye muscles. The prosthetic and orbital implant work together like ball and socket joint.
The prosthetic eye is made and fitted by an ocularist. Ocularists are certified by the National Examining Board of Ocularists. Dr. Vidor works closely with outstanding ocularists and is happy to assist in arranging a consultation. In addition, the following can help find a board certified ocularist in your area
Sometimes a prosthetic socket requires additional surgery to improve its appearance or hold the prosthetic itself. In addition, patients with prosthetic eyes can develop the same conditions, such as eyelid ptosis or ectropion, which anyone else with a sighted eye may have. Dr. Vidor is an expert at anophthalmic (prosthetic) socket reconstruction. He frequently takes on some of the most difficult prosthetic socket cases and works closely with the ocularist to ensure the best possible cosmetic result and maximum comfort.