During an evisceration, the contents of the eye are removed, leaving the sclera behind. The cornea may also be removed. Some ophthalmologists contend that patients experience better motility after evisceration than enucleation, but this issue is not settled. Evisceration is contraindicated when an intraocular tumor is suspected.
Because many fragments of tissue are removed from the eye, the pathologist has more difficulty in assessing pathologic changes.
Sympathetic ophthalmia has been reported following evisceration, but this complication is rare.
The cornea should be submitted together with all fragments of tissue from the intraocular contents.
We recommend that pathologists submit all tissues from the evisceration specimen. Rarely, a neoplasm will be discovered within such eyes. Also, in cases of evisceration following trauma, it is important to assess the uveal tissue for the possible presence of granulomatous inflammation (sympathetic ophthalmia).
Examination of evisceration specimens is analogous to assembling pieces of a jigsaw puzzle. Often, a great deal of information can be learned from these specimens, but the distortion in anatomy makes it much more difficult to reconstruct the circumstances leading to the demise of vision than examination of entire eye at enucleation.
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