Evisceration and enucleation (removal of an eye)
The removal of an eye is sometimes used to treat conditions such as eye cancer and very severe infections. It can also be an option for people with a blind eye that is very painful.
Whatever the reason for needing eye removal surgery, it's a big decision, and it's natural to feel worried about the operation and how living with one eye will change your life. You'll probably need time to adjust, physically and emotionally. You'll need some time to recover from the operation and get used to wearing an artificial eye.
You might be surprised to learn that it's possible to adapt well to living with monocular vision (having vision in only one eye). If the vision in your remaining eye is good, it can learn to work together with your brain to compensate for the removed eye.
What can lead to removal of an eye?
Various conditions can lead to eye removal surgery. The removal of an eye will only happen if other treatments fail or if it's the only safe option, for example, with eye cancer.
The main causes for eye removal surgery include:
- Eye cancer - such as retinoblastoma, melanomas or other life-threatening tumours that need to be removed.
- Serious eye injury or trauma - severe enough to mean the eye cannot be saved.
- Severe infection in a blind eye.
- A very painful eye with no vision - for example, in someone in the end stage of an eye disease like glaucoma.
Facing the loss of your eye can be a very emotional time, even when it is the best or only option for your health. In some cases, you might spend time discussing the option with your eye doctor before deciding. Even if the eye makes life very painful or difficult, it's not an easy decision to reach.
What happens during the removal of an eye?
Before you have the operation to remove your eye, you'll have some pre-operation checks. You'll tell your ophthalmologist and surgeon about any medicine you take, and the surgeon will advise which to keep taking before the operation.
The operation happens under sedation; you'll be given a general anaesthetic. Exactly how the eye is removed depends on the choice of surgical procedure. Your eye doctor will discuss which surgical technique is appropriate with you beforehand, so you know what to expect.
Types of eye removal surgery
What happens after eye removal surgery?
After your surgery, a large dressing will be taped in place over the eye to aid healing and reduce inflammation. Your eyelid may be sewn shut to hold the conformer in place and help recovery.
How long you stay in the hospital can depend on your recovery from the general anesthetic. It can also vary depending on the hospital, but most people don't stay more than a couple of nights. You won't be able to drive yourself home, so plan ahead and try to arrange a lift if possible.
You might have medicine to take while you recover, such as antibiotics, steroids and painkillers. If bruising or swelling makes you uncomfortable, you can also take over the counter painkillers at home.
You'll need to keep your bandage dry and keep it on for as long as the surgeon has told you. You'll have a follow-up appointment, usually a week after the operation, when the surgeon will check how your eye is healing.
It may be two to four weeks before you can do some activities like swimming, strenuous exercise, and heavy lifting. Ask your surgeon if there is anything you're not sure about doing.
After a couple of months when you’re fully healed, you should be ready to have your prosthesis (artificial eye) fitted. An ocularist (someone who makes artificial eyes) will paint your prosthesis, made from ophthalmic plastic. It should be a very good colour match to your other eye.
Your prosthetic eye can last many years. You'll see your ocularist and eye surgeon for follow-up appointments when they'll look at the health of your eye socket and check the condition of your prosthetic eye.
What is monocular vision?
If you've had one eye removed, you'll rely on the other eye for your sight. When you only have vision in one eye, this is known as monocular vision (binocular vision is when you can see with both eyes).
It can take some adjustment to monocular vision. Your perception of depth and field of vision will be affected. With time, your non-affected eye will take over and working with your brain, it will eventually compensate for the loss of vision in the other eye.
It can be frustrating getting used to the change in your vision, but there are many practical ways you can cope in the meantime.
Living with sight loss in one eye
If you've been used to good vision in both eyes, it will take a while to get used to seeing with one eye. You might need to take extra care doing everyday activities that involve judging distances, such as walking up and downstairs, pouring drinks, and getting around outside. There are lots of ideas that can help with practical life skills while you adjust.
Frequently asked questions
Medically reviewed by: The Royal College of Ophthalmologists on 18/10/2022
Edited by: Nick Astbury FRCS FRCOphth FRCP
Clinical Associate Professor
The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.