Eye socket reconstruction is usually required after eye removal. Patients may present with an asymmetrical appearance.  The artificial eye may appear deep-set compared to the other side. The upper eyelid may appear sunken or lower than it should be.


In cases whereby there is not enough volume in the eye socket after eye removal we will often aim to increase the volume by either exchanging your current orbital implant for a larger one; this is known as a secondary orbital implant. In some cases a secondary orbital implant is not possible and the volume will be replaced using fat taken from the abdomen. This will be discussed with you when planning the surgery.


There are many different implants available which each have their own risks and benefits. The commonly used implants are acrylic, hydroxyapatite (coral) and porous polyethylene (Medpor®). The use of any given implant depends on a number of factors including your age, the size of the socket, the degree of possible implant. The reason for eye removal can impact the choice of orbital implant. As discussed previously, in some cases we will use fat from your abdomen instead of an orbital implant.  This is usually in cases when the risk of using the other types of implant is too high.


The most common risks associated with an orbital implant include infection and exposure or extrusion of the implant.  In some cases there may be quite marked bruising within and around the eye socket.


Prior to surgery the team will see you in clinic and discuss the treatment options with you at this stage. If you are happy to go ahead with surgery we will normally consent you for the operation and you will need to sign a form.

You may then need to be pre-assessed for the surgery whereby a nurse will ask you some questions about your general health should the doctor feel that this is necessary. On occasion we may take some blood tests and may ask you change your medications prior to surgery. The pre-assessment may take place on the day of your clinic visit, on a subsequent day or even over the telephone.


On the day of surgery you will be told a time and place to come to the hospital. You will be met by the nursing team and one of the surgical team will also see you.

Often when after eye socket surgery you will need to stay in hospital overnight and will need to bring some overnight clothes and toiletries for the duration of your stay. We advise that you also bring in your medications with you when you come into hospital.

Sometimes you may have to wait for a few hours before your surgery is performed and this depends on your position on the operating list. A general anaesthetic is usually preferred when performing eye socket surgery and the anaesthetist will also come and see you.


Often after eye socket surgery your eye will be padded for 3-4 days. You will be booked for review within the first week to have the pad removed. In the first few days after surgery you will be prescribed an oral antibiotic. You may feel nauseous or even feint at times shortly after surgery to the eye socket.

On removing the pad you will be able to see a clear conformer (shell) in the eye socket which will stay in place for the initial 4-6 weeks. Your eyelids may be a little swollen and this will usually settle within a few days.

Mr Norris will show you how to clean your eyelids and socket and how to apply an antibiotic ointment.


Normally we ask that you keep the wounds around your eye clean after surgery. You can clean the wound by allowing boiled water to cool and gently dabbing the wounds with a cotton bud.

We will give you some antibiotic ointment (usually Chloramphenicol) to apply to the wounds and to the eyes after the surgery to help protect against infection.

We do not normally need to remove any stitches unless you have had simultaneous eyelis surgery.

You should avoid any strenuous activity including lifting heavy objects for at least two weeks and avoid swimming for three weeks after surgery.


Usually after we exchange your orbital implant you will need to have new prosthetic shell (artificial eye) fitted.  This will match the new contours of your eye socket.


In many cases when performing orbital implant surgery we may need to perform surgery to either the upper or lower eyelids. This may be performed simultaneously or in some cases some weeks after your new artificial eye has been fitted.  Mr Norris will discuss this with you in clinic.


Usually patients are quite anxious after having surgery near their eyes and most problems do settle with time. If you developed a reduction of vision in your other eye or if there is bleeding or severe swelling then you should seek medical attention. Mr Norris will happily see you with any problems. Please refer to the emergency contact page (under the header ‘Contact’) if you need advice.


Author: Mr Jonathan Norris FRCOphth