Not Something an Oculoplastic Surgeon Likes to See - Part 1

Two of the many advantages of being an ophthalmologists are: 1. one can usually guarantee a good night sleep and 2. rarely do one need to face with life-and-dead decision. And being an oculoplastic surgeon, there is the added advantage that most procedures can be planned ahead for optimal outcomes. However, one occasionally see extreme gross pathology in patients who neglect their conditions necessitating big unpleasant but life-saving procedure. 

This man had a growth in his right eye about three years ago, an ophthalmologist in another town did a biopsy and confirmed the diagnosis of conjunctival squamous cell carcinoma. The man refused further treatments and did not return for follow-up. When he was eventually bought to the clinic by concerned relative because of foul smell emitting from the right eye, his whole eye and its surrounding tissues have been destroyed by the fungating tumour. 

To prevent the spread of tumour into the brain which could kill the patient, the only procedure of choice is orbital exenteration. The procedure involves removal of all eye socket contents, including muscles, the lacrimal gland system, the optic nerve as well as varying parts of the bone of the orbit. 

Front view of the fungating tumour that destroyed 

all the orbital contents and eyelids.

Side view of the tumour.