CHAPTER VII
ENUCLEATION OF THE GLOBE AND ALLIED OPERATIONS
The principal substitutes for simple enucleation are evisceration, Mules’s and Frost’s operations.
ENUCLEATION
Enucleation is the removal of the globe from Tenon’s capsule.
Indications. Enucleation should be performed in preference to Mules’s operation in—
| (i) | Malignant tumours. |
| (ii) | Injuries followed by cyclitis. |
| (iii) | Painful blind eyes. |
In malignant tumours enucleation should only be performed when there are no signs of extra-ocular extension. If extra-ocular extension be present, evisceration of the orbit should be performed, provided there be no evidence of general metastasis. In cases of glioma of the retina it is especially desirable that the optic nerve should be cut as far back as possible and the cross-section carefully examined for gliomatous tissue, since the disease spreads to the brain along this structure.
In injuries followed by non-suppurative cyclitis enucleation or Frost’s operation is preferable to Mules’s operation, since cases have been recorded of sympathetic ophthalmia following the latter operation, and it is these cases of non-suppurative cyclitis which are especially prone to give rise to that disease.
Blind painful eyes, especially when affected with glaucoma, are best removed, as occasionally the underlying cause, when not known, may prove to be an intra-ocular growth.