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February 9, 2009

Should Evisceration Ever Be Done in a Blind, Painful Eye?

Arch Ophthalmol. 2009;127(2):211-212. doi:10.1001/archophthalmol.2008.604

In this issue of Archives, Eagle and coauthors present 7 cases of inadvertent evisceration of eyes containing uveal melanoma and conclude: “ . . . we believe that the risk of inadvertently eviscerating an eye containing an unsuspected malignant neoplasm probably is greater than the risk of sympathetic uveitis.”1 The relative risks of evisceration vs enucleation have been argued repeatedly in the peer-reviewed ophthalmic literature and is a topic in which feelings among ophthalmologists are “highly polarized.”2 The article by Eagle et al emphasizes one of the most dreaded fears of evisceration: leaving behind an undetected ocular melanoma, which subsequently can result in metastatic disease. Despite the relatively small number of cases in this series, we believe that this article will serve a very important function.

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