Enucleation of eye ball

The Removal of the globe

Enucleation : the removal of the globe and nictitating membrane.

Exenteration : removal of the globe, nictitating membrane, orbital contents and lid margins.

WHY MIGHT THIS PROCEDURE COME TO BE NECESSARY?

It has no chance of being capable of sight and it is painful.

Trauma to the eye - scratch to the eye that becomes infected - hitting the eye on something sharp

Tumors of the eye

Glaucoma

Endophthalmitis, panophthalmitis

Herpes infection related ulcers on the eye (in cats) are all catastrophes to the eye.

Others create a painful blinded eye.

Brachycephalic breeds

cataract ulcer

glaucoma trauma Cornea erosion

Orbital anatomy

Medial wall frontal, maxillary, lacrimal, zygomatic bones

Caudomedial wall presphenoid, basisphenoid, palatine bones

Anatomy

Dog medial and dorsomedial wall of the orbit

Cat entirely bone ; zygomatic process, frontal process come into proximally

Anatomy

Anatomy

Enucleation

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Patients signalmentsName : Species : canineBreed : schnauzerSex : FemaleAge : about 1 yr Weight : 5 kgB.T : 38.0 R.R : 40 / minPurse : 130 / min

CBC & Serum chemistry

RBC 725 * 104 /ul 540 ~780 x 104

WBC 16.5 * 103 /ul 6~17 x 103

PCV 35 % 37~54Fibrin 200 mg/dl 100~400Total Protein 7.8 g/dl 6.0~7.8BUN 11.5 mg/dl 10~25Creatinine 0.7 mg/dlAST 53.5 U/L

Preoperative treatment

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Preoperative treatment - Anesthesia

1 ( GPS 0.1ml/kg I.M )

15~20 Atropine Sulfate 0.04 mg/kg, S.C. Zoletil50 7 mg/Kg, I.V.

Procedure

Ventral recumbency

Draping ocular surgery

Eye wash 2~10% povidone - iodine in saline

Procedure

Procedure

Procedure

Suture

- conjunctiva, Tenons capsule, orbital septum : simple interrupted sutures of 4-0 absorbable

- subcutaneous layer : simple continuous sutures of 4-0 absorbable

- Skin : simple interrupted of 4-0 nonabsorbable

Procedure

After surgery

Orbital prosthesis

Implantation of silicone prosthesis after enucleation or exenteration reduces the facial distortion

Post operative care

Elizabethan collar

WHAT SIGNS WOULD INDICATE A PROBLEM?Infection Remaining swollen after the initial week the incision may drain pus If this occurs, the infection would require drainage and antibiotics.

If the eye was enucleated due to a severe tear or rupture, the eye may not be removed in one piece.

Sometimes a small fragment of the rear eye membranes remains behind. If enough of this tissue is present, secretion of fluid can continue and chronic oozing from the incision can be a problem. If this is excessive, the eye socket may require a second surgery to be fully cleaned out. Both these complications are very rare.

References

Small animal surgery, Mosby, Cheryl S.Hedlund

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