Case 29: Traumatic Evisceration

  • Natalie HomerEmail author
  • Seanna Grob
  • Katherine E. Talcott
  • Daniel R. Lefebvre


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.


Globe perforation Evisceration Zygomaticomaxillary complex fracture Orbital floor fracture Facial laceration 


  1. 1.
    Savar A, Andreoli MT, Kloek CE, Andreoli CM. Enucleation for open globe injury. Am J Ophthalmol. 2009;147(4):595–600.e1.Google Scholar
  2. 2.
    Vaca EE, Mundinger GS, Kelamis JA, Dorafshar AH, Christy MR, Manson PN, Rodriguez ED. Facial fractures with concomitant open globe injury. Plast Reconstr Surg. 2013;131(6):1317–28.Google Scholar
  3. 3.
    Rahman I, Maino A, Devadason D, Leatherbarrow B. Open globe injuries: factors predictive of poor outcome. Eye (Lond). 2006;20:1336–41.Google Scholar
  4. 4.
    Hatton MP, Thakker MM, Ray S. Orbital and adnexal trauma associated with open-globe injuries. Ophthal Plast Reconstr Surg. 2002;18:458–61.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Natalie Homer
    • 1
    Email author
  • Seanna Grob
    • 1
  • Katherine E. Talcott
    • 2
  • Daniel R. Lefebvre
    • 1
  1. 1.Department of OphthalmologyHarvard Medical School, Massachusetts Eye and EarBostonUSA
  2. 2.Vitreoretinal SurgeryWills Eye HospitalPhiladelphiaUSA

Personalised recommendations