The removal of an eye is a subject of grave consideration in the mind of the patient as well as the physician. It ranks in the lay mind with the major operations, such as the removal of a limb, not only as a matter of sentiment, but even in the scale of damages allowed by the accident insurance corporations and by the courts in suits for payment of damages. The loss of visual range over an arc of approximately 60 degrees, and the resulting deformity, often sufficiently apparent to seriously impede the earning capacity, are also factors in the production of the unwillingness on the part of the patient to submit to the operation, and must be met by cogent and convincing reasons on the part of the medical attendant.
If the promise can be given of a minimum of apparent defect, with a maximum of safety or benefit in
HEPBURN NJ. THE RELATIVE INDICATIONS FOR ENUCLEATION AND THE MULES OPERATION. JAMA. 1902;XXXIX(8):423–426. doi:10.1001/jama.1902.52480340017001f
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