Case 29: Traumatic Evisceration

Abstract

A 34-year-old man presented after a metal wheel grinder struck his left face, and was found to have extensive facial fractures, periorbital soft tissue lacerations and a severely deformed left globe. Due to extensive globe injury, a preoperative discussion and consent for possible primary evisceration with ocular implant placement and facial reconstruction was undertaken with the patient. Surgical exploration revealed an unsalvageable globe. Intraoperatively the patient’s ruptured scleral tissue was identified, but there was complete absence of intraocular contents, indicating no chance of vision restoration. An implant was placed in the scleral shell and the extensive facial fractures and soft tissue injuries were repaired by the oculoplastic service, yielding an excellent cosmetic result. Primary implant placement can be considered during the initial surgery in patients with traumatic evisceration without chance of vision restoration.