Case 30: Traumatic Enucleation

  • Liza M. CohenEmail author
  • Alice C. Lorch
  • Michael K. Yoon


A 41-year-old woman presented with a Zone III open globe injury of the right eye with no light perception vision and concurrent traumatic enucleation of the left eye due to assault. She underwent bilateral globe exploration with repair of the ruptured right globe and placement of an orbital implant on the left. She experienced persistent eye pain and no light perception vision on the right and subsequently underwent enucleation of the right eye with placement of an orbital implant 1 week later. Traumatic enucleations are rare, often caused by manual gouging injuries in instances of assault or self-induced. Bilateral severe eye injuries, such as this, are also rare, but are particularly devastating to the patient and family. These cases must be managed appropriately, both surgically as well as psychologically.


Traumatic enucleation Bilateral open globe injury Assault Orbital implant 


  1. 1.
    Shneck M, Oshry T, Marcus M, Lifshitz T. Attempted bilateral manual enucleation (gouging) during a physical assault. Ophthalmology. 2003;110:575–7.CrossRefPubMedGoogle Scholar
  2. 2.
    Aboud ND, Shah P, Sullivan F. Assessment and management of manual traumatic enucleation. Aust N Z J Ophthalmol. 1995;23:55–7.CrossRefPubMedGoogle Scholar
  3. 3.
    Tai AX, Mattern RM, Schaefer DP, Borke JA. Traumatic manual enucleation (gouging) from assault. Clin Exp Ophthalmol. 2016;44(7):628–30.CrossRefPubMedGoogle Scholar
  4. 4.
    Hariprasad SM, Shah GK, Mieler WF, et al. Vitreous and aqueous penetration of orally administered moxifloxacin in humans. Arch Ophthalmol. 2006;124:178–82.CrossRefPubMedGoogle Scholar
  5. 5.
    Schellini S, El Dib R, Silva LR, et al. Integrated versus non-integrated orbital implants for treating anophthalmic sockets. Cochrane Database Syst Rev. 2016;11:CD010293.PubMedGoogle Scholar
  6. 6.
    Large MM, Nielssen OB. Self-enucleation: forget Freud and Oedipus, it’s all about untreated psychosis. Br J Ophthalmol. 2012;96(8):1056–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Liza M. Cohen
    • 1
    Email author
  • Alice C. Lorch
    • 1
  • Michael K. Yoon
    • 2
  1. 1.Department of OphthalmologyHarvard Medical School, Massachusetts Eye and EarBostonUSA
  2. 2.Ophthalmic Plastic Surgery, Department of OphthalmologyMassachusetts Eye and Ear Infirmary, Harvard Medical SchoolBostonUSA

Personalised recommendations