The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Post-enucleation socket syndrome

Photo by Professor Chua Chung Nen

This 70 year-old woman seeks help to improve her right ocular appearance. Her right eye was removed 30 years-ago because of trauma but no ocular implant was inserted. In the past few years she noticed progressive ptosis and endophthalmos as well as difficulty in keeping the prosthesis in good position. This is typical of post-enucleation socket syndrome which is characterised by deep superior sulcus and inferior displacement of the prosthesis due to volume loss and fat atrophy. It is best treated with implant replacement and lower lid laxity by lid tightening e.g. canthal sling. The ptosis may improve when the volume is replaced and a better prosthesis inserted.

 

Endophthalmos and ptosis due to loss of socket volume.

The prosthesis is displaced inferiorly.

 

Sunken sulcus typical of post-enucleation syndrome.

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