Eye evisceration

I am 80 + yrs old. I had a severe eye injury at the age of 21. I have had 4 corneal transplants and a "tube" operation to relieve eye pressure. I cannot have any more surgeries due to the condition of my eye. I have phthisis bulbi (end stage eye disease) and uveitis. I have been doctoring with a cornea specialist and I have to wear a bandage contact lens and I am using combigan, pred forte, lumigan, and polytrim plus moisture drops. Will my eye qualify for evisceration surgery? Will I have to have enucleation surgery? How long before I have to make a decision? My doctor tells me he doesn't know how long before I have to have surgery and he is just trying to keep any infection from occurring and maintain the current status. I am scared to death not knowing answers regarding the process? The earliest appointment is July before I can see a Ophthalmologic Plastic & Reconstructive Surgeon for answers and reevaluation. How long before my eye starts shrinking? So many questions.

Hello, and sorry to hear about your eye. Also, sorry to hear you have to wait until July to talk to a knowledgeable doctor about your options. I had an evisceration one year ago after 40 years of uveitis and glaucoma in both eyes. Had the tubes inserted in the '90's but the one on my right eye began to fail in 2010 and had to be removed. I could have lost that eye then, but was afraid to. Hindsight as it is, wish I'd had guts back then. I was at risk for infection this time, and I have artificial joints all over my body so could not afford to risk that. I opted for the evisceration and ocular prosthesis. Um, currently, though, I had a bit of trouble with my prosthesis. It caused some irritation, and I am leaving it out until I see the surgeon again tomorrow. Treating it with amoxycillin and antibiotic ointment. I will need to have the prosthesis adjusted. I can update you tomorrow or Tuesday after I see the surgeon if you're interested. Otherwise, I'm happy to answer any questions that I can or offer support. Hang in there! I know it's hard to deal with a painful eye and the potential loss of something so precious. Wishing you all the best.

Hello, and sorry to hear about your eye. Also, sorry to hear you have to wait until July to talk to a knowledgeable doctor about your options. I had an evisceration one year ago after 40 years of uveitis and glaucoma in both eyes. Had the tubes inserted in the '90's but the one on my right eye began to fail in 2010 and had to be removed. I could have lost that eye then, but was afraid to. Hindsight as it is, wish I'd had guts back then. I was at risk for infection this time, and I have artificial joints all over my body so could not afford to risk that. I opted for the evisceration and ocular prosthesis. Um, currently, though, I had a bit of trouble with my prosthesis. It caused some irritation, and I am leaving it out until I see the surgeon again tomorrow. Treating it with amoxycillin and antibiotic ointment. I will need to have the prosthesis adjusted. I can update you tomorrow or Tuesday after I see the surgeon if you're interested. Otherwise, I'm happy to answer any questions that I can or offer support. Hang in there! I know it's hard to deal with a painful eye and the potential loss of something so precious. Wishing you all the best.

Renyt, I'm sorry, I had not seen this comment before I responded above. In 2010, I was threatened with enucleation. The discussion was about the types of prostheses used back then, and I didn't like my options. It wasn't a glassy eye, but some other kind of material. I really don't know that procedure. This time, I saw a surgeon first, who sent me to an ocularist. AS soon as the ocularist looked at me, he said, "have you considered an evisceration?" I actually had to do something, and I thought that my best protection and aesthetic was the evisceration with a cosmetic prosthetic after it healed. I let it heal for 4 months. I sometimes wore a patch in public, but as someone with tons of scars and deformities as a result of my Juvenile Arthritis since age 2, I no longer care (that much) about how others perceive me. The prosthesis was for me. But I can't put it in by myself because of the limitations in my hands and elbows. I am legally blind so can't drive, and my cervical spine is fused so putting drops in requires me to lie down. My husband helps me a lot!

So, here's what I think. Learn what you can about the differences between evisceration and enucleation, and maybe Amanda can help with that. I don't know what artificial eyes are like for enucleations, but they could be similar. Mine is a polished polymer kind of thing, custom crafted to match exactly with my other eye. BTW, I hear some folks have fun with theirs and put little images of their pets or sports teams inside the pupil! Weird but fun! Also, you will need help for either surgery with getting there and going back home. So, maybe you can contact someone who would be willing to come help you for a time. Or maybe there are resources in the community or with your insurance to get you through this? You might want to talk to the surgeon about this.

Your eye will look very different after surgery. It will need time to heal. It will be painful like a headache for a couple of days or so. I know you've been through a lot and dread going through anymore. I know this because I've had over 40 surgeries in my 58 years. I don't know how much more I can take either. Be gentle and kind to yourself. Know your options and the consequences. Ask good questions of doctors, the supports you find here, and yourself. Can you keep your current eye? Can you simply wear a patch after the surgery?

Here's the other thing I can tell about you: you are very strong. You have endured much already, and none of it's fair, but you have seen your own resilience through your own experiences and ability to survive. Again, I wish you all the best and I will happily try to answer any other questions. I need to go back and listen to your last comment now and see if I missed anything, so sorry if I did.
Terri

Terri, congratulations on the new artificial eye. So good to get your update! I bet there is quite the art to creating an artificial eye. Incredible that today the artificial eye moves in tandem with the good eye. I had no idea about the need to replace them every 5 years or so, but that makes sense.

In reply to @tlt "Hello all, I'm here today to update you on my artificial eye. I was fitted with..." + (show)
Did you have an evisceration or enucleation? Thank you - RENYT

Your article was most helpful. Just knowing what to expect helps. You healed for 4 months before continuing with the replacement prosthetic - was this due to your other health issues or is it best to heal for a long period first? I am concerned about the surgeon doing the surgery. I have read a lot about surgeons who are specialized in Ophthalmology Plastic and Reconstructive surgery. I did not want just "any" eye surgeon doing the surgery - especially if I have to have an enucleation. I searched for surgeons who had a 5 star rating and had acquired a Fellowship medical designation. Since I live near Kansas City, MO I located two within the Fellowship medical doctor's listing. I decided on the one I have an appt with in July, 2022. Probably this is the reason I have to wait 3 months for my appointment. Hopefully, I have chosen well! The physician I am currently with, his specialty is corneal transplants. I was referred to him by another ophthalmologist when my eye condition was deteriorating and I was becoming concerned what the problems were. This doctor immediately found the problem and began treatment. He is trying to prevent any infection from occurring. I have only been under the care of this doctor for 1 1/2 months. I had several questions he said he could not answer regarding evisceration and enucleation and recommended I talk to the surgeon in his medical clinic. I could not find any reports regarding the surgeon therefore I decided to get a reevaluation from the doctor I selected from my research of physicians with a Fellowship designation. Maybe I am being too concerned regarding which surgeon I go to? We lived in Minnesota many years before moving to Missouri. Three of my four eye surgeries were performed at Mayo Clinic as well as my breast cancer and my husbands colon cancer. If it wasn't for the distance where we live now I would return to Mayo for my current eye issues. We could not be more pleased with Mayo! Thank you for your message and will appreciate anything else you have to share with me. Your struggles have been much more than mine and bless you for enduring your health issues. We thank God he gives us the strength to handle the issues we face in our lives. May you have a beautiful day. Sorry for my long post. RENYT

Thank you and I hope you will soon be comfortable. Yes - I am interested in the process you went thru. Who decided that evisceration surgery was the best route to go? I don't know if I have a choice. Anyway - when you feel like replying I would love to know more about what I am facing. Namely - how painful was the recovery? Wishing you the best RENYT

Pain was manageable and minimal over the time period of those months. Right after surgery, and for maybe a week, I had enough pain to take tramadol prescribed by my surgeon. The worst pain was on the way home and that first evening after surgery, but by that I mean it was about a 5 on the 0 (no pain) to 10 (take me to the ER) scale. Tylenol was also used for the few mild headaches I had during weeks 2 and 3 post op. But hey, what a good excuse to rest and listen to an audio book? So that's what I did. I hope this is helpful