Enucleation and Evisceration in the Gambia

The decision to remove an eyeball is usually a difficult one for both surgeon and patient. From the surgeon's position, it is an acceptance of total defeat at any efforts that may have been made to salvage the vision or the eyeball. For the patient, the loss is enormous since any form of artificial replacement of the organ is usually functionless, (vision wise). At best an improved cosmetic appearance is all that is achieved. This study highlights those factors that cumulate in the removal of the eyeball either by enucleation or by evisceration. The commonest is endophthalmitis/panophthalmitis which was responsible for 51% of cases. This was followed by staphyloma which make up 24.7%. Other causes include orbital/ocular tumours 8.1%, trauma 5.8%, painful blind eye 5.8%, and phthisis 4.5%. Over 75% of enucleated/eviscerated eyes were due to preventable or treatable causes most important of which is infection which is the underlying factor in cases of endophthalmitis/panophthalmitis and staphyloma. Health Education to improved awareness as well as improvement in the socio-economic conditions of the general populace will go a long way in reversing this trend. Nigerian Journal of Ophthalmology Vol. 8, No.1 (August 2000): pp 29-33