Causes for removal of the eye: a study of 890 eyes

This study is a review of 890 cases of eye enucleations performed over a period of 22 years. The major cause for enucleations was trauma, accounting for 39.7% of the eyes enucleated. Chronic inflammatory diseases accounted for 22.1%, glaucoma for 11.5% and tumours for 9.2% in this group. Retinal diseases were responsible for 5.5% of the eyes; vascular occlusion for 5%; and miscellaneous causes for the remaining 7%. Injuries were everyday tools and small flying missiles caused most of the trauma. Previously planned surgical operations accounted for 15% of the enucleations. Forty-eight of these eyes had epithelial or fibrous downgrowths resulting from inflammation, secondary glaucoma, and phthisis bulbi. A more careful selection of cases and better surgical techniques might significantly lower these statistics. Also, vascular occlusion should be given a high level of suspicion in all intractable cases of glaucoma of unexplained etiology. As a general rule, enucleations should not be performed because of the suspected presence of sympathetic ophthalmia.