What are surgical options for a NON-VISUAL eye with primary glaucoma?

• A. Enucleation +/- Orbital Prosthesis; Evisceration With Prosthesis; Chemical Ciliary Body Ablation With Cidofovir Or Gentamicin
• B. Enucleation +/- Orbital Prosthesis
• C. Cyclodestructive Laser Only
• D. Corneal Transplantation

Answer: (A)

When a glaucoma-affected eye is no longer useful for vision, the goal shifts to pain relief and cosmetic rehabilitation. There are a few main surgical routes, and the strongest option for a non-visual eye integrates both globe removal and globe-sparing approaches.

Enucleation removes the entire globe and is often followed by fitting an orbital prosthesis to preserve appearance. Evisceration, which removes the contents inside the eyewall but leaves the scleral shell and muscles intact, also allows a prosthetic eye to restore cosmesis. If the surgeon prefers to keep the eye’s outer shell in place, chemical ciliary body ablation provides a globe-sparing way to reduce aqueous production and lower intraocular pressure by destroying the ciliary body with chemical agents. This approach can relieve pain in a blind glaucomatous eye while preserving the cosmetic shell, though it involves different risks and trade-offs compared with removing the eye.

Corneal transplantation isn’t indicated here because it doesn’t address intraocular pressure or pain in a non-visual glaucomatous eye. Cyclodestructive laser is another option in some contexts, but the stated set of surgical options best covers globe removal or chemical destruction of the ciliary body to manage a painful, non-seeing eye with glaucoma.