What to Expect After Your Enucleation Surgery

This information explains how to care for your eye socket after your enucleation (ee-NOO-klee-AY-shun) surgery. In this resource, the words “you” and “your” refer to you or your child.

After Your Surgery

Before your surgery, you may have been instructed to stop taking some of your usual medications. Examples include anticoagulants (blood thinners), aspirin, fish oils, and vitamin E. After your surgery, talk with your primary care provider or prescriber (the healthcare provider who prescribes you medication). Ask them when you can start taking anticoagulants again. You can go back to taking aspirin, fish oils, and vitamin E 48 hours (2 days) after your surgery.

Caring for your eye socket

Children

Right after your surgery, you’ll have a dressing covering your eye socket and your eyelid will be closed. Before you’re discharged (released) from the hospital, your healthcare provider will check your eye to make sure it’s okay.

The next day (the day after your surgery), you’ll see your healthcare provider again. During this time, they’ll take off your dressing and place an eye patch over your eye. They’ll also show your parents how to change your eye patch when you’re at home.

You’ll need to wear an eye patch for 4 weeks (1 month) after your surgery. Make sure to change your eye patch every day until your follow-up appointment.

When you’re at home, you can wash your face as usual with water and a clean cloth. You can shower or bathe as usual, but don’t put your head underwater (in a bathtub, swimming pool, or the ocean) until 2 weeks after your surgery.

If you have any pain, take acetaminophen (Tylenol^®). Don’t take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin^® or Advil^®) and naproxen (Aleve^®).

Your ophthalmologist (eye doctor) will give you a prescription for tobramycin and dexamethasone (TobraDex^®) ointment. You’ll apply the ointment between your eyelids. Before you apply the ointment, wash your hands with soap and water first. Then, gently pull down your lower eyelid. Squeeze a very small amount of ointment (about the size of a grain of rice) into your eye socket. Then, let go of your eyelid. Close your eye for 1 to 2 minutes, so the ointment can reach all parts of your eye socket. When you’re done, wash your hands with soap and water again. Apply the ointment 2 times a day. Do this every day until your follow-up appointment.

If you run out of ointment before your appointment, check with your pharmacy to see if you have refills. If you don’t have any refills, call your ophthalmologist’s office at one of the numbers listed in the “Contact Information” section.

Don’t rub, press, or bump your eye socket. It may take some time for you to get used to seeing out of only 1 eye.

Adults

Right after your surgery, you’ll have a dressing covering your eye socket and your eyelid will be closed. Before you’re discharged (released) from the hospital, your healthcare provider will check your eye to make sure it’s okay. They’ll change your dressing and show you how to change it when you’re at home.

When you’re at home, make sure to keep your dressing dry. Don’t put your head under water. Shower or bathe only from the neck down.

If you have any pain, take acetaminophen (Tylenol^®). Don’t take nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin^® or Advil^®) and naproxen (Aleve^®).

Keep your dressing on for at least 2 days, or as directed by your ophthalmology team.

After you take off your dressing, you can wash your face as usual with water and a clean cloth. You can shower or bathe as usual, but don’t put your head underwater (in a bathtub, swimming pool, or the ocean) until 2 weeks after your surgery.

Your ophthalmologist (eye doctor) will give you a prescription for tobramycin and dexamethasone (TobraDex^®) ointment. After your dressing is off, you’ll apply the ointment between your eyelids. Before you apply the ointment, wash your hands with soap and water first. Then, gently pull down your lower eyelid. Squeeze a very small amount of ointment (about the size of a grain of rice) into your eye socket. Then, let go of your eyelid. Close your eye for 1 to 2 minutes, so the ointment can reach all parts of your eye socket. When you’re done, wash your hands with soap and water again. Apply the ointment 2 times a day. Do this every day until your follow-up appointment.

If you run out of ointment before your appointment, check with your pharmacy to see if you have refills. If you don’t have any refills, call your ophthalmologist’s office at one of the numbers listed in the “Contact Information” section.

Don’t rub, press, or bump your eye socket. It may take some time for you to get used to seeing out of only 1 eye.

Side effects

For the first few weeks after your surgery, you may have:

• Bruising and swelling around your eye socket
• Watery or pink-colored drainage (leftover blood and tears)
• A “scratchy” feeling in your eye socket
• Mild discomfort around your eye socket

These side effects are common and will go away within a few days.

Plastic conformer

During your surgery, your ophthalmologist will put a soft plastic or silicone conformer between your eyelids. It will help keep the shape of your eye.

Your conformer may fall out in the first few days or weeks after your surgery. If you feel comfortable putting the conformer back in, you can do so. Before you put it back in, clean it with soap and water first. Then put the conformer back in between your eyelids, just like how you would put in a contact lens. If you don’t feel comfortable doing this, bring the conformer with you to your next appointment. A member of your ophthalmology team will put it back in for you.

Children don’t need to replace their conformer if it falls out.

Adults can choose to wear an eye patch until they receive their prosthesis (artificial eye), but it isn’t needed. If you want to wear an eye patch, you can buy disposable eye patches at your local pharmacy. If you don’t want to wear an eye patch, you can wear sunglasses instead.

Follow-Up Appointment

You’ll need to schedule your follow-up appointment when you’re discharged from the hospital. Your ophthalmology team will tell you when you should schedule it for. Follow-up appointments for children and adults are usually scheduled for 4 weeks (1 month) after their surgery. Call your ophthalmologist’s office at one of the numbers listed in the “Contact Information” section to schedule your appointment.

After your follow-up, your ophthalmologist will ask you to schedule an appointment with an ocularist. An ocularist is someone who makes and fits prosthetic eyes. Your ocularist will design your prosthesis to match your other eye. Your ophthalmology team can recommend an ocularist. You’ll need to check with your insurance company to make sure they’re covered under your insurance plan.

Children don’t need to get a prosthetic eye if they don’t want to.

When to Call Your Healthcare Provider

Call your ophthalmologist if you have:

• Orbital pain (pain inside your eye socket) that doesn’t get better after taking Tylenol
• Headaches that don’t get better after taking Tylenol
• Nausea (feeling like you’re going to throw up)
• Vomiting (throwing up)
• Bleeding through the dressing
• Yellow-colored or green-colored drainage

If you have a fever of 100.4° F (38° C) or higher, call your ophthalmologist right away.

Contact Information