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Surgical removal of eyes in a tertiary institution in North eastern Nigeria



Authors: Olatunji F.O., Ibrahim F.U., Ayanniyi A.A., Azonobi R.I., Tukur R.B., Maji D.A. Correspondence to: Dr Fatai O Olatunji, Ophthalmology Department, University of Ilorin Teaching Hospital, Ilorin. P.O.Box 1003, Asunara, Ilorin. Kwara State, Nigeria, GSM: +234 803 3912 863 E-mail:




Surgical eye removal is performed for various end-stage eye diseases to provide adequate comfort, replace volume and give good functional and cosmetic appearance. The pattern of eye removal is unknown for North Eastern Nigeria.



To determine the indications for eye removal in the study community.



Records of all the patients whose eyes were removed between January 2002 and December 2008 were reviewed retrospectively. Age, sex, diagnosis and type of surgery were recorded.



A total of 67 eyes were removed during the period consisting of 46 males (68.7%). Mean age was 29.5 years (range 4 months to 90 years). Indica-tions for surgery were trauma, 26 (38.8%), infection, 21 (31.3%), anterior staphyloma, 14 (20.9%), tumor 4, (6.0%) and painful blind eye, 2 (3.0%).


Evisceration was performed in 55 (82.1%), enucleation, 11 (16.4%) and exenteration, 1 (1.5%) patient. In children (n = 28), the indications were trauma and anterior staphyloma in 10 patients (35.7%) each, tumor in 4 (14.3%), infection in 3 (10.7%) and painful blind eye (mooren's ulcer) in 1 (3.6%) of the children respectively. In adults (n = 39), indications were in-fections, 18 (46.2%), trauma, 16 (41.0%), anterior staphyloma, 4 (10.3%) and painful blind eye due to advanced glaucoma, 1 (2.6%).



Trauma, infections, and anterior staphyloma were the major indications for eye removal. Most of the indications were avoidable.


Enucleation or evisceration is performed for various end-stage eye diseases. The affected eye is removed to provide adequate comfort from pain in painful blind eyes of any etiology, to replace volume and give good cosmetic appearance in phthisis and anterior staphylo-ma, to prevent spread of infection and malignancy in in-fectious and malignant diseases and reduce risk of sym-pathetic ophthalmia from penetrating eye injuries (1). Evisceration involves the removal of the corneal leaving an intact scleral shell. Enuclecation is the removal of the entire diseased globe from the orbit, by separating its connections (extra ocular muscles and the optic nerve). In exenteration the globe and all (total exenteration) or part (partial or modified exenteration) of the orbital soft tissues and ocular adnexas are removed. Indications for each procedure vary with changing trends in disease management and may reflect the pattern of severe ocular diseases in a given community.or the level of advance-ment in management of ocular diseases. Apart from trauma that is a common indication for eye removal in both developed and developing worlds (2-6), the more com-mon indications in the developed world are intraocular malignancy (3,7-9) and a blind, painful eye (3,10,11). In most reports from developing world infections (pan ophthalmitis) (4-6, 12) and sequelae of preventable corneal diseases are still common (12,14). The study centre is a tertiary health institution in Bauchi state, in the north eastern geopolitical zone of Nigeria. Although many studies on indications for eye removal have been carried out in Nigeria, majority are in the southern parts of the country (4,5, 12). The north eastern zone of the country has the highest prevalence of blindness out of the 6 geopolitical zones (13). The community is under-served. Prior to 2002 there was no full time opthamolo-gist in the hospital. Other ophthalmologists including most of the co-authors in the study, practice in the centre part-time during their holidays/leave periods. The study objective was therefore to determine the indications for eye removal in the study community.




Records of all the patients who underwent surgery for eye removal by evisceration, enucleation or exentera-tion