Prosthetic Eye Surgery

Prosthetic Eye Surgery (Evisceration and Enucleation)

Losing an eye is a life-changing experience — both physically and emotionally. Whether due to injury, disease, or a painful blind eye, the decision to undergo surgery is never taken lightly. Prosthetic eye surgery refers to procedures in which the eye is surgically removed and replaced with a natural-looking prosthetic (artificial) eye. This includes two types of surgery: evisceration and enucleation.

Miss Ting is an experienced oculoplastic surgeon with expertise in the surgical and long-term management of patients undergoing eye removal. She offers careful support through each step of the journey — from surgery to prosthetic fitting and beyond.

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When Is Prosthetic Eye Surgery Needed?

Surgery may be recommended for:

• A painful blind eye

• Severe eye injury with no chance of vision recovery

• Cancerous tumours inside the eye

• Cosmetic concerns from a disfigured, non-seeing eye

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What’s the Difference Between Evisceration and Enucleation?

• Evisceration: The inner contents of the eye are removed, while the outer white wall (sclera) is preserved. This approach is often used for blind, painful eyes without concern for tumour.

• Enucleation: The entire eye is removed, including the sclera. This is usually required for intraocular tumours, trauma, or other conditions where preserving the sclera is not safe.

Both surgeries involve placing an orbital implant to restore volume and prepare the socket for a natural-looking prosthetic eye.

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Understanding the Emotional Impact

Miss Ting recognises that the decision to proceed with eye removal can feel overwhelming. It's common to experience sadness, anxiety, or uncertainty about appearance. Her approach is compassionate, and she works closely with patients and their families to provide support, information, and realistic reassurance.

The good news is that with modern surgery and a high-quality prosthesis, many patients go on to feel confident and comfortable again — often with very little visible difference in appearance.

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What Is the Process?

1. Surgery (Evisceration or Enucleation)
   The procedure is performed under general anaesthetic. An orbital implant is placed at the time of surgery to maintain volume and natural movement. A temporary clear shell is placed behind the eyelids during healing.

2. Healing Period (6–8 Weeks)
   The eye socket needs time to settle before the final prosthesis can be fitted.

3. Custom Prosthetic Eye Fitting
   Once healing is complete, Miss Ting will refer patients to an ocular prosthetist who will craft a bespoke artificial eye, matched in size and colour to the natural eye. The prosthesis is usually well tolerated and moves with the gaze, offering a highly natural appearance.

4. Ongoing Care
   Regular follow-up is provided to ensure comfort, fit, and cosmetic satisfaction. The prosthesis can typically be worn full time and removed occasionally for cleaning.

 

What Is Post-Enucleation Socket Syndrome (PESS)?

Some patients may develop Post-Enucleation Socket Syndrome (PESS) over time (usually many years after initial surgery). This refers to a group of changes in the socket after eye removal, including:

• Deepening of the upper eyelid sulcus (a hollowed appearance)

• Drooping of the lower eyelid

• Enophthalmos (the implant or prosthesis sitting too far back)

• Reduced movement of the prosthetic eye

Miss Ting offers surgical adjustments to address PESS, such as:

• Lower lid tightening or support surgery

• Orbital implant revision

• Dermis fat grafting to restore lost volume

• Eyelid or socket reconstruction as needed

These procedures help improve the cosmetic appearance and function of the socket, ensuring a comfortable fit for the prosthesis.

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A Long-Term Supportive Approach

Prosthetic eye surgery is not just about the operation — it’s about helping patients feel whole again. Miss Ting provides long-term, thoughtful care for both adults and children undergoing eye removal, offering a balance of medical excellence and emotional support.

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Next Steps

If you’re considering eye removal surgery or have a long-standing prosthetic eye and are experiencing issues, Miss Ting can provide a detailed consultation and individualised treatment plan.

Please contact us to arrange an appointment or ask any questions in confidence.