LESSON 1: Eye, Ear, Nose, and Throat (EENT) Surgery

Section I: EYE SURGERY

1-12

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1-12. PROCEDURES ON THE EYEBALL

a. Enucleation. This is excision of the eyeball and its muscles, with or without introduction of an implant (device made of glass or plastic used to prevent unsightly appearance of the eye and to form, a base for a prosthesis). Enucleation is sometimes indicated as treatment following penetrating or crushing wounds of the eyeball, and upon diagnosis of certain other conditions--especially the threat of sympathetic ophthalmia. (Sympathetic ophthalmia is bilateral inflammation of the entire uveal tract.) The condition is nearly always secondary to a perforating wound of the eye. Sympathetic ophthalmia nearly always progresses to blindness unless the injured eye ("exciting eye") is removed before the disease is well underway in the other eye ("sympathizing eye"). The anesthesia of choice for this operation is general anesthesia.

b. Evisceration. In contrast to enucleation, evisceration is excision of the cornea and removal of all contents of the globe, leaving the scleral shell and muscles intact. The procedure is indicated following injury when a virulent organism invades the eye. Evisceration provides less danger of the transmission of infection to the brain than does enucleation. General anesthesia is usually used for this procedure.

c. Exenteration of Orbit. This is the removal of the entire contents of the orbit (eye, tendons, muscles, fatty and fibrous tissue). The operation is indicated as treatment for malignant tumor. General anesthesia is usually given for this procedure.

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