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Removal of blind or injured eyes

Enucleation/Evisceration is the removal of the eye. This type of ocular surgery is indicated for
a number of ocular tumors, in eyes that have suffered severe trauma, and in eyes that are
otherwise blind and painful. Removal of the eye by enucleation or evisceration can relieve pain
and minimize further risk to life and well-being of an individual with the above noted conditions.

In addition, procedures to remove the eye should address the resultant appearance of the orbit.
Orbital implants and ocular prostheses are used to restore a more natural appearance.

An orbital implant is placed after removal of the eye to restore volume to the eye socket and
enhance motility of an ocular prosthesis and eyelids. To avoid a sunken appearance to the eye
socket, an implant approximating the volume of the eyeball can be placed into the space of the
removed eye and secured in the socket by suturing Tenon's capsule and conjunctiva (essentially
the skin of the eyeball) over the implant. Implants can be made of many materials with the most
common being plastic, hydroxylapatite, silicone or glass.

About two months after the initial surgery, once the conjunctiva has healed and post-operative
swelling has subsided, an ocular prosthesis can be placed to provide the appearance of a natural
eye. The prosthesis is fabricated by an ocularist. The external portion of the ocular prosthesis is
painted and finished to mimic a natural eye color, shape and luster. It can be removed and
cleaned periodically by the individual or a care giver.

The two part system of orbital implant and ocular prosthesis provides a stable, and well tolerated
aesthetic restoration of the eye socket. Although vision is not restored by removal of the eye with
placement of an orbital implant and ocular prosthesis, a natural appearance can result. The
implant, along with the attached, visible ocular prosthesis, can be moved by intact extraocular
muscles that will track or move simultaneously with the other eye. The eyelids are able to move
and blink over the prosthesis as well.

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