What is the treatment for chronic luxations that are blind/painful?

• A. Orbital exenteration
• B. Enucleation or evisceration + prosthesis
• C. Antibiotics and analgesics
• D. Observation

Answer: (B)

Relieving the pain and restoring appearance requires removing the diseased globe. When a luxated globe is chronic, blind, and painful, definitive removal of the eye—either enucleation (removing the entire globe including the optic nerve) or evisceration (removing the intraocular contents while preserving the scleral shell)—followed by placement of a prosthetic eye, is the best course. This eliminates the source of pain and allows a comfortable cosmetic result.

Antibiotics and analgesics do not address the structural issue or the pain from a dislocated, nonfunctioning eye. Observation leaves the pain and risk of ongoing inflammation. Orbital exenteration is far more radical and is reserved for cases with malignant disease or extensive orbital involvement, not for a nonmalignant chronic luxation.