[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Ophthalmology](https://durgical.com/en/ophthalmology/) › [Eye surgery and procedures](https://durgical.com/en/ophthalmology/areas/surgery/) › Enucleation, evisceration and the artificial eye # Enucleation, evisceration and the artificial eye - Topic A blind, painful eye or an eye with a tumour can be removed. An orbital implant and a custom-made artificial eye restore volume, movement and appearance. Updated Nov 13, 2026 **See it in 3D:** [Eye fascia](https://durgical.com/en/anatomy/suspensory-ligament-of-eyeball/) · [Optic nerve](https://durgical.com/en/anatomy/optic-nerve/) · [Eyelids](https://durgical.com/en/anatomy/superior-tarsus/) ## Key points - Enucleation = whole globe; required for tumours. - Evisceration = contents only; never with a possible tumour. - Implant + conformer, then a custom artificial eye. - Exposed implant or persistent discharge: refer. - Protect the remaining eye; think of sympathetic ophthalmia. ## What it is Enucleation removes the whole globe and cuts the optic nerve; it is the operation for intraocular tumours such as retinoblastoma and uveal melanoma. Evisceration removes the contents of the eye and keeps the sclera and muscles; it is quicker, gives better movement and is used for blind, painful eyes and severe endophthalmitis, but never when a tumour is possible. In both, an orbital implant replaces volume, a clear shell (conformer) holds the space, and a custom acrylic artificial eye is fitted once the swelling settles. ## Key facts - Indications: intraocular tumour (enucleation), blind painful eye, endophthalmitis that does not respond, a globe destroyed by trauma, and a shrunken eye (phthisis) for appearance. - Before evisceration in an eye with no view of the fundus, ultrasound or imaging excludes a hidden tumour. - Implants are porous (tissue grows into them) or non-porous; the muscles are attached to them to give movement. - The prosthesis is fitted several weeks after surgery by an ocularist and polished and refitted over the years. - Late problems: implant exposure or extrusion, discharge, a contracted socket, lid laxity or droop, and a sunken upper lid (post-enucleation socket syndrome). - In young children, the orbit needs the stimulus of an implant and enlarging conformers to grow symmetrically. ## In clinical practice - Sympathetic ophthalmia is a rare bilateral granulomatous uveitis after injury or surgery of one eye; light sensitivity or blurred vision in the remaining eye is urgent. - Chronic discharge is usually mucus from an ageing or ill-fitting prosthesis or poor hygiene, but a visible implant means exposure. - One-eyed patients should wear polycarbonate safety glasses to protect the remaining eye. ## Next step / Initial management - Blind, painful eye: refer to ophthalmology to discuss options (drops, cyclodestruction, retrobulbar injection, evisceration or enucleation). - Before any removal with no view of the fundus: imaging to exclude an intraocular tumour. - Socket discharge: check hygiene and prosthesis fit; refer if it persists, is bloody or the implant is visible. - Pain, swelling or an exposed implant in the socket: refer soon (infection or extrusion). - Red eye, light sensitivity or reduced vision in the remaining eye: same-day ophthalmology (sympathetic ophthalmia). ## Test yourself Think of the answer, then tap the question to see it. ## Which operation is used to remove an eye with a uveal melanoma, enucleation or evisceration? Enucleation, which removes the whole globe; evisceration could leave tumour behind. ## What must be done before eviscerating a blind eye with no view of the fundus? Ultrasound or other imaging to exclude an intraocular tumour. ## Weeks after an eye injury, the other eye becomes red and blurred. What must be suspected? Sympathetic ophthalmia; same-day ophthalmology. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/ophthalmology/enucleation-evisceration-and-the-artificial-eye/) ## Connections ## See it in 3D 3 The structures of Durgical's 3D anatomy where it is found. - [Eye fascia](https://durgical.com/en/anatomy/suspensory-ligament-of-eyeball/) - [Optic nerve](https://durgical.com/en/anatomy/optic-nerve/) - [Eyelids](https://durgical.com/en/anatomy/superior-tarsus/) ## Related 4 - [Ocular ultrasound and point-of-care scanning](https://durgical.com/en/ophthalmology/ocular-ultrasound-and-point-of-care-scanning/) - [Eye pain and painful visual loss](https://durgical.com/en/ophthalmology/eye-pain-and-painful-visual-loss/) - [The orbit, orbital septum and eyelids](https://durgical.com/en/ophthalmology/the-orbit-orbital-septum-and-eyelids/) - [Glaucoma lasers and surgery: from iridotomy to tube shunts](https://durgical.com/en/ophthalmology/glaucoma-lasers-and-surgery-from-iridotomy-to-tube-shunts/) ## Related conditions 5 - [Retinoblastoma](https://durgical.com/en/conditions/retinoblastoma/) - [Uveal melanoma](https://durgical.com/en/conditions/uveal-melanoma/) - [Endophthalmitis](https://durgical.com/en/conditions/endophthalmitis/) - [Sympathetic ophthalmia](https://durgical.com/en/conditions/sympathetic-ophthalmia/) - [Ocular trauma: hyphema and open globe injury](https://durgical.com/en/conditions/ocular-trauma-hyphema-and-open-globe-injury/) [← All of ophthalmology](https://durgical.com/en/ophthalmology/) Educational content; not a clinical guideline and no substitute for assessment by a health professional. For sudden visual loss, severe eye pain, a chemical burn or an eye injury, go to an emergency department at once. Sources: [Anophthalmic Socket](https://www.ncbi.nlm.nih.gov/books/NBK606099/) (StatPearls Publishing (NCBI Bookshelf), 2024); [Enucleation](https://www.ncbi.nlm.nih.gov/books/NBK562144/) (StatPearls Publishing (NCBI Bookshelf), 2023); [Evisceration](https://eyewiki.org/Evisceration) (EyeWiki (American Academy of Ophthalmology), 2025). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/ophthalmology/enucleation-evisceration-and-the-artificial-eye/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/ophthalmology/enucleation-evisceration-and-the-artificial-eye/