Spectrum of Ocular Pathologies Leading to Evisceration and Enucleation: A Tertiary Care Set Up Study

Abstract

Objective: To determine the spectrum of ocular pathologies leading to evisceration and enucleation in a tertiary care hospital.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Al-Shifa Trust Eye Hospital, Rawalpindi, from 6th January 2025 to 12th January 2026.
Materials and Methods: A total of 120 patients who underwent evisceration or enucleation were included in the study. Non-probability consecutive sampling technique was used. Data was collected on a self-structured proforma that included sections for demographics, clinical presentation, diagnosis/indication for surgery, Bscan ultrasonography findings, histopathological findings, surgical procedure, implant placement, and preventability status. Data were analyzed using SPSS version 25. Age was expressed as mean ± standard deviation, while categorical variables were presented as frequencies and percentages. Chi-square test and Fisher–Freeman–Halton exact test were applied for association between categorical variables, and independent samples t-test was applied for comparison of mean age between traumatic and non-traumatic groups. A p-value of ≤0.05 was considered statistically significant.
Results: The mean age was 40.4 ± 17.9 years. Male patients were more frequently affected, 78 (65.0%). Evisceration was performed in 74 (61.7%) patients, while enucleation was performed in 46 (38.3%) patients.Ocular trauma was the most common indication, 52 (43.3%), followed by endophthalmitis/panophthalmitis, 24 (20.0%), and corneal ulcer/perforation, 16 (13.3%). Most patients presented with no perception of light, 88 (73.3%), and 92 (76.7%) cases were classified as preventable. Histopathology mainly showed inflammatory/infective changes, 62 (51.7%). A statistically significant association was observed between indication and preventability (p < 0.001), while gender showed no significant association with etiology,
procedure, or visual acuity.
Conclusion: Ocular trauma and infective ocular pathologies were the leading causes of evisceration and enucleation, and most cases were potentially preventable. Early referral, timely treatment of ocular infections, and preventive eye safety measures may reduce severe ocular morbidity and the need for globe removal procedures.