Exenteration
Exenteration is the surgical removal of the
eyeball and the surrounding tissues
including the eyelids, eyeball muscles and
orbital soft tissue.
What is exenteration?
During an exenteration, the eyeball and
muscles surrounding the eye and part of
the eyelids are removed, as well as the
surrounding soft tissues in the socket.
The part of the eyelids that has the lashes
is also removed during the operation. The
remaining space is covered by the
residual surrounding skin.
Why do I need an exenteration?
This operation is sometimes necessary to
prevent a tumour from spreading to the
surrounding structures in the eye.
What are the possible complications of
an exenteration operation?
Short-term complications can include
bleeding, swelling and infection. Long-
term complications can include discharge
and socket irritation or thinning of the
socket lining.
Moorfields Eye Hospital NHS Foundation Trust
City Road, London EC1V 2PD
Phone: 020 7253 3411
www.moorfields.nhs.uk
Before your surgery
You can take your tablet medication as
normal, except for anticoagulants, such as
aspirin, clopidogrel and warfarin.
Please note:
If you are taking blood thinning drugs e.g.
aspirin, clopidogrel or warfarin, please
speak to your consultant or eye doctor
and staff in the pre-operative assessment
clinic.
On the day of surgery
You will be given a general anaesthetic
which means you will be asleep during the
operation.
You must not have any food for at least
six hours before surgery, and no drinks for
two hours before surgery.
Please take your regular blood pressure
tablets with a sip of water on the day of
surgery, but omit any tablets with a name
ending in -PRIL and -TAN (eg EnalaPRIL
or LosarTAN). This is because these
drugs could lower your blood pressure
while you are under general anaesthetic.
Be careful: some tablets will have more
than one name on the packet.
Before you are given the general
anaesthetic, you will be assessed by an
anaesthetist and your surgical team will
ask you to sign a consent form. The team
will also mark your forehead to indicate
which eye is to be removed.
How long does the operation take?
The operation takes about an hour and a
half.
What will happen after the operation?
A pressure dressing will be placed on your
eye and you will go back to the ward after
surgery. Most patients having this
operation will need to stay overnight.
The pressure dressing over your eye will
be removed at your first follow-up
appointment about one week after
surgery.
The nurse will show you how to clean the
area surrounding the wound with cool,
boiled water.
Take care not to touch the wound itself.
You may wash the rest of your face as
normal.
Do not blow your nose for two weeks after
the operation as this can cause air to pass
into the wound and could spread any
possible infection.
Moorfields Eye Hospital NHS Foundation Trust
City Road, London EC1V 2PD
Phone: 020 7253 3411
www.moorfields.nhs.uk
Try to sleep upright with three or four
pillows for two weeks after the surgery as
this helps prevent the wound from
becoming swollen, and will help with the
healing process.
Once the wound has healed, the
surrounding skin will feel tight and will
take a few months to settle down.
At a later stage, the eye socket can be
covered with a prosthesis, which mimics
the appearance of the eye and eyelids.
The prosthesis can be attached to glasses
to hold it in the correct place.
Will I need medication?
You will be asked to take medications
after surgery such as eye drops,
antibiotics, steroids or pain-relief.
Follow up
It is important to attend follow-up
appointments as the remaining tissues in
the socket will need to be inspected to
ensure the tumour does not recur.
Careful monitoring of the socket by the
patient is also important and it is vital to
report any new changes that appear as
soon as possible.
Can I drive after an exenteration?
You can drive as long as the vision in your
normal eye meets the legal requirements
for driving and you have an adequate field
of vision. You will need to remember that
your overall vision will be reduced and you
will have to turn your head more
frequently while driving to compensate for
the lack of vision on one side, however
you will adapt. You will also need to take
extra care when driving at night.
By law you are required to inform the
Driver and Vehicle Licensing Authority
(DVLA) of any change in your health and
sight that is likely to affect your driving.
You must also inform your insurance
company. The DVLA drivers’ medical
enquiries advice line – 0300 790 6806 –
will be able to advise on what information
to provide and help inform your insurance
company about your eye removal.
Author: Crina Guarino, Mr George Saleh
Revision number: 2
Approval date: May 2017
Review date: May 2019
Moorfields Eye Hospital NHS
Foundation Trust
City Road, London EC1V 2PD
Phone: 020 7253 3411
www.moorfields.nhs.uk
Moorfields Direct telephone helpline
Phone: 020 7566 2345
Monday–Friday, 8.30am–9pm
Saturday, 9am-5pm
Information and advice on eye conditions
and treatments from experienced
ophthalmic-trained nurses.
Moorfields Eye Hospital NHS Foundation Trust
City Road, London EC1V 2PD
Phone: 020 7253 3411
www.moorfields.nhs.uk
Patient advice and liaison service
(PALS)
Phone: 020 7566 2324 or 020 7566 2325
Email: pals@moorfields.nhs.uk
Moorfields’ PALS team provides
confidential advice and support to help
you with any concerns you may have
about the care we provide, guiding you
through the different services available at
Moorfields. The PALS team can also
advise you on how to make a complaint.
Your right to treatment within 18 weeks
Under the NHS constitution, all patients
have the right to begin consultant-led
treatment within 18 weeks of being
referred by their GP. Moorfields is
committed to fulfilling this right, but if you
feel that we have failed to do so, please
contact our patient advice and liaison
service (PALS) who will be able to advise
you further (see above). For more
information about your rights under the
NHS constitution, visit
www.nhs.uk/choiceinthenhs.