Categories: HEALTH & WELLNESS

My Eye Removal

When I was five, I lost the sight in my left eye due to a brain tumor growing on my optic nerve. Although the optic nerve was removed, I was allowed to keep my eye. I wore a prosthetic eye shell over the eye as it had atrophied. After more than 45 years, doctors decided to remove the diseased eye because it was painful. The inside of the eye itself had become hard, so anytime I moved the eye, it hurt.. As I had been blind since the age of five, losing the eye was not an issue.The worst part was not knowing what to expect during the surgery. I hope my story will help others that are dealing with the same situation so they will know what to expect.

There are two types of eye removal surgery. An evisceration occurs when the material inside the eye is removed, a plastic orb is placed inside the eye skin to hold the shape and the skin is closed. This type of surgery allows for more false eye movement, as the eye skin or sclera is still attached to muscles. The alternate surgery, an enucleation, involves removing the entire eye. A whole false eye orb is placed in the eye socket and it is often attached to muscles. The deficit of an enucleation is the lack of false eye movement. If a patient is given an option, an evisceration results in better false eye movement and is preferred. This is the surgery that I had performed. Knowing the process of having an evisceration makes it easier to experience.(http://medtextfree.wordpress.com/2010/12/29/chapter-97-enucleation-evisceration-and-exenteration/)

Pre Surgery

The doctor will perform an eye exam and explain why the surgery is needed. Often they show a video explaining the procedure or give the patient a website to look at. After an initial consulation, the doctor wll refer you for blood work and lung xrays. After the blood work is complete and forwarded to the operating doctor, a follow up visit and surgery date are planned. The doctor verifies at this appointment that all plans have been made and you are ready for surgery.

Day of Surgery

On the day of surgery, a patient reports to the same day eye surgery center. Surgery is often performed early in the morning to allow for recuperation time. A nurse escorts the patient to the pre-op room where vitals are recorded. An x is marked above the eye to be operated on so there will be no mistakes during surgery. An IV is started and the nurses will explain what type of medications will be administered. Generally you will be given something to relax you prior to surgery. The nurse in charge of the preoperative room wheels you to surgery and hands you over to the operating nurse and anesthesiologist. The anesthesiologist will explain what to expect as far as medication and sleep. I was administered medication via an IV. This is the preferred method of anesthesiology. Your doctors may or may not be present prior to surgery. Mine did check in on me to ask if I had any questions. As I was drifting off to sleep, I noticed each doctor had a head lamp that would illuminate my eye for surgery. As I was dopy, I found this humorous and made a comment. Do not be surprised if you act a bit silly before finally falling asleep. Rest assured that the anesthesiologist is by your side the entire time. It is nice to know you have someone watching you. If you are cold, do not hesitate to ask for a blanket. My nurse provided a heated blanket. Many people fear being put under not knowing how it will feel. Imagine falling asleep with no difficulty. It was not scary or did not feel odd – just instant sleep.

Post Surgery

Upon awaking, my pain was minimal. You might find that your face feels stiff. Your good eye might be a bit hazy but nurses will place eye drops in the eye to clear up vision. A bandage will have been placed over the operated eye, covering the entire lid area also. Some patients experience slight nausea, so let your nurse know if you feel sick. Each patient is different, but I was out the door in the car on the way home in less than 2 hours after surgery.The doctor will probably prescribe pain medication and something for nausea. Before leaving, you will be instructed when to return to see your doctor. Instructions will be given about bandage care and bathing. The eye area must be kept dry, so baths are preferred. If the bandage comes off, extra gauze and bandages are given. But generally, the bandage should remain in place until the follow up appointment. Mine was 2 days later, but this is not always the case. When arriving home, you will be a bit sleepy due to the medication. Do not be surprised if you do not want to eat much the first day. Dizziness and a slight headache might be an after effect of the anesthesia. Driving is out of the question for the first day. It is best to rest during the first day or two following surgery. Some discomfort might be felt when bending down or stooping, so avoid these positions. It is best to take pain medication as prescribed to avoid any un needed pain. (http://www.asoprs.org/files/public/infoenucevis.pdf)

Post Op Follow Ups

At the first post op appointment, the doctor examines the eye for healing and applies a new bandage. A patient usually returns again in 2 or 3 days for a follow up visit, when the bandage will be removed. The operated eye can be left bare or an eye patch worn. I chose to wear an eye patch when going out as the eye remains red and I was afraid children might be scared by an eye with no iris or pupil. The doctor will refer the patient to an eye specialist who makes false eye shells. A follow up visit with the eye doctor is then scheduled for a month. Before you can be fitted with an eye, it will need to heal. This process is individual and takes longer in some people. The socket takes a couple of months to heal totally so a false eye will have the best fit. Waiting is difficult as no one likes to wear an eye patch, but the end result is worth it.I was teaching at the time, so chose to wear sunglasses to school. The children would probably have loved the eye patch better as their teacher would have been a pirate!

Life After Surgery

Remember that they eye contents have been removed, so do not be alarmed when looking in a mirror. The remaining eye will be red and will lack an iris or pupil. It simply serves as a basis for the future shell. It also will appear sunken in a bit, but this is normal as the content of the eye is now a plastic orb. The false eye will be built up to fill in the space. As I have dealt with a blind eye my entire life, this experience was not traumatic. However, for those just losing an eye, it is a life changing event. Your doctor may be able to refer you to a local support group with others who have just experienced the lose of an eye. Sharing your experience and knowing you are not alone often helps. The eye will hardly be noticeable after the shell. Sometimes I still receive comments especially from children. I simply tell them I have a sore eye. To adults who are curious, I explain that I had a brain tumor as a child. Knowing what to say in advance helps if questions arise.