{"id":6458,"date":"2019-04-21T15:41:00","date_gmt":"2019-04-21T13:41:00","guid":{"rendered":"https:\/\/ver-ooginoog.nl\/bibliotheek\/wearing-an-ocular-prosthesis-after-enucleation-or-evisceration-surgery\/"},"modified":"2026-09-15T15:58:52","modified_gmt":"2026-09-15T13:58:52","slug":"wearing-an-ocular-prosthesis-after-enucleation-or-evisceration-surgery","status":"publish","type":"library_pt","link":"https:\/\/ver-ooginoog.nl\/en\/library\/eye-removal\/wearing-an-ocular-prosthesis-after-enucleation-or-evisceration-surgery\/","title":{"rendered":"Wearing an ocular prosthesis after enucleation or evisceration surgery"},"content":{"rendered":"<div class=\"wp-block-post-date\"><time datetime=\"2019-04-21T15:41:00+02:00\">21 April 2019<\/time><\/div>\n<p class=\"wp-block-paragraph\">Although this is his first presentation to patients, he certainly recognizes the importance of connecting with them on a day like this. Because not only can the eye patients learn something from his story, but\u2014as a doctor\u2014he can learn a great deal from the patients\u2019 stories, H\u00f6tte emphasizes. \u201cAnd future patients, in turn, benefit from that.\u201d A win-win situation, in other words. Having said that, he goes on to discuss the various situations in which a patient might wear a prosthesis: after an enucleation or an evisceration, or a prosthesis or cosmetic contact lens over the patient\u2019s own eye. H\u00f6tte also mentions exenteration, a procedure in which other parts of the eye socket are removed as well, but due to time constraints, he is unable to go into further detail on that.     <\/p>\n<h2 class=\"wp-block-heading\">Enucleation<\/h2>\n<p class=\"wp-block-paragraph\">For a patient with a malignant tumor in the eye, enucleation\u2014that is, the removal of the entire eye\u2014is performed. H\u00f6tte uses diagrams to show that the entire eyeball is removed during enucleation, but that the muscles and the mucous membrane covering the eyeball remain intact. The implant used to fill the eye socket is attached to the muscles. The mucous membrane is then closed over the implant. The prosthesis is placed over that. According to H\u00f6tte, the goal of enucleation is the complete removal of the malignant tumor. It can then be examined by a pathologist. In the past, enucleation was also performed for a painful, blind eye or an eye that was cosmetically unsightly, but nowadays doctors opt for evisceration in these cases. H\u00f6tte refers to this as a \u201cshift\u201d that has taken place among doctors over the past few decades.        <\/p>\n<h2 class=\"wp-block-heading\">  Evisceration<\/h2>\n<p class=\"wp-block-paragraph\">This is a procedure that is currently used to treat a painful blind eye or a blind eye that is cosmetically unsightly. Not the entire eye is removed during this procedure, as the sclera and the optic nerve remain intact. The implant is then placed within the sclera. The sclera and the conjunctiva are then closed over the implant, and the prosthesis is placed on top of it. According to H\u00f6tte, the major advantage of evisceration is that more tissue is preserved. \u201cAnd the fewer anatomical changes there are, the better the outcomes,\u201d says H\u00f6tte.       <\/p>\n<h2 class=\"wp-block-heading\">Prosthetic over the natural eye<\/h2>\n<p class=\"wp-block-paragraph\">\u201cIt\u2019s certainly not always necessary to remove a blind eye that\u2019s cosmetically unsightly,\u201d says H\u00f6tte. In such cases, a doctor places a prosthesis over the patient\u2019s own eye, but this is contingent on the patient not experiencing any pain in the eye. Additionally, the eye must have shrunk because it is no longer in use. Only then is there enough space for the thick prosthesis. And tests must be conducted to determine whether the patient still has sensation in the cornea. If that is the case, the mucous membrane must be sutured over the cornea through a simple procedure, because it would then be too sensitive for the patient to wear the prosthesis directly on the eye, explains H\u00f6tte. If there is no longer any sensation in the cornea, the prosthesis can be placed directly on the eye.      <\/p>\n<h2 class=\"wp-block-heading\">Cosmetic contact lens<\/h2>\n<p class=\"wp-block-paragraph\">Sometimes there isn\u2019t enough room in the eye for such a thick prosthesis, but even then, according to H\u00f6tte, there\u2019s a solution: a cosmetic contact lens. This contact lens is also placed directly on the patient\u2019s own eye and \u201chides\u201d the unsightly eye. H\u00f6tte has clearly summarized the vast amount of information about the various procedures and ways of wearing an ocular prosthesis in a flowchart (see image). He then walks us through the process of preparing a patient for surgery. He discusses the different surgeries and what each entails. Notably, while many doctors insert a so-called \u201cconformer\u201d\u2014a type of plastic cap designed to keep the mucous membranes apart\u2014after surgery, the eye hospital immediately fits a temporary prosthesis. \u201cWe believe this helps with early acceptance of a prosthesis,\u201d explains H\u00f6tte.        <\/p>\n<h2 class=\"wp-block-heading\">Experiences<\/h2>\n<p class=\"wp-block-paragraph\">He briefly goes over the postoperative factors (poor depth perception, but also what to do if the prosthesis falls out), but then H\u00f6tte is mainly curious about the experiences of the people in the audience. The stories mainly revolve around whether or not to keep the prosthesis in at night. Some patients find it uncomfortable to keep the prosthesis in, while others are bothered by having to put it in and take it out constantly. H\u00f6tte explains that there\u2019s no one-size-fits-all approach in this area, because every patient\u2019s situation is different. \u201cEveryone should do what feels right.\u201d A man in the audience also mentions that after his surgery, he was not fitted with a temporary prosthesis or a conformer. The patient in question also mentions that he didn\u2019t find the experience pleasant and that the eye socket only started to feel better once the ocularist fitted him with a temporary prosthesis. Finally, H\u00f6tte would like to discuss complications following surgery, such as drooping eyelids and persistent pain after an enucleation or evisceration, as well as ongoing studies.         <\/p>\n","protected":false},"excerpt":{"rendered":"<p>Ophthalmologist Gijsbert H\u00f6tte had the honor of kicking off the National Contact Day in April with his presentation on wearing ocular prostheses and the various procedures involved. H\u00f6tte works at the Eye Hospital in Rotterdam and specializes in problems involving the eye socket, eyelids, and tear ducts. The young ophthalmologist admits to being a bit nervous, as this is his first presentation to patients. But as soon as he begins his talk, those nerves melt away like snow in the sun.     <\/p>\n","protected":false},"featured_media":6459,"template":"","meta":{"_acf_changed":false,"_daextauttol_enable_tooltips":""},"library_cat":[122],"class_list":["post-6458","library_pt","type-library_pt","status-publish","has-post-thumbnail","hentry","library_cat-eye-removal"],"acf":[],"_links":{"self":[{"href":"https:\/\/ver-ooginoog.nl\/en\/wp-json\/wp\/v2\/library_pt\/6458","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ver-ooginoog.nl\/en\/wp-json\/wp\/v2\/library_pt"}],"about":[{"href":"https:\/\/ver-ooginoog.nl\/en\/wp-json\/wp\/v2\/types\/library_pt"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ver-ooginoog.nl\/en\/wp-json\/wp\/v2\/media\/6459"}],"wp:attachment":[{"href":"https:\/\/ver-ooginoog.nl\/en\/wp-json\/wp\/v2\/media?parent=6458"}],"wp:term":[{"taxonomy":"library_cat","embeddable":true,"href":"https:\/\/ver-ooginoog.nl\/en\/wp-json\/wp\/v2\/library_cat?post=6458"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}