Which of the following is a treatment option for chronic luxations that are blind/painful?

• A. Enucleation or evisceration + prosthesis
• B. Observation
• C. Oral antibiotics
• D. Lasik

Answer: (A)

For a chronically luxated eye that is blind and painful, the priority is to relieve pain and restore cosmetic appearance, which is achieved by removing the nonfunctional globe and fitting a prosthetic. Enucleation removes the entire globe including the optic nerve, eliminating the source of pain and reducing risk of future inflammatory or sympathetic issues, and is followed by placement of a prosthetic eye. Evisceration removes the intraocular contents while preserving the sclera and extraocular muscles, also allowing a prosthetic to be fitted for a natural appearance. Both options address the underlying problem directly: a painful, nonseeing eye that can no longer contribute to vision or meaningful function. By contrast, observation would leave pain unresolved; oral antibiotics don’t treat a nonfunctional, painful eye; Lasik is a refractive procedure for a living, refractive eye and does not address dislocation or pain.