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Vision in Focus: Understanding Trends in Eye Removal and What It Means for You

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Jordan Keane in Health & Wellness December 2025 • 4 min read.

"A deep dive into the histopathological review of 2009 enucleation cases, exploring the changing landscape of eye health and treatment in Asian Indian patients."


Enucleation, the surgical removal of the eye, remains a critical procedure for end-stage ocular diseases, despite advancements in globe-salvaging treatments. Understanding the reasons behind enucleation and how these reasons change over time is vital for improving eye care and public health strategies. A recent study delved into a comprehensive review of enucleation cases in Asian Indian patients, offering valuable insights into the shifting trends in eye health.

This retrospective study, encompassing 2009 patients who underwent enucleation over a 22-year period, sheds light on the primary causes, age-related factors, and changing patterns of ocular diseases leading to eye removal. By examining histopathological diagnoses and clinical data, researchers have uncovered significant trends that have implications for both medical professionals and the general public.

This article breaks down the key findings of this research, explaining the major causes of enucleation, how these causes vary across different age groups, and what the observed trends mean for the future of eye care. Whether you're a healthcare provider, a patient with eye concerns, or simply interested in understanding the landscape of eye health, this analysis provides crucial information.

Key Findings: Causes and Trends in Enucleation

Symbolic image of an eye transforming into a tree, representing vision and growth.

The study revealed several significant findings regarding the reasons for enucleation in the Asian Indian patient population. Malignant tumors were the predominant cause, accounting for 73% of cases. Retinoblastoma, a cancer of the retina, was the most common malignancy, particularly in young children. Other notable causes included acute trauma (5%), retinal vascular diseases (3%), and inflammatory/infective pathologies (2%). A substantial portion of cases (23%) fell into a miscellaneous/non-specific diagnosis category.

One of the most striking findings was the shift in the prevalence of different causes over the 22-year study period. There was a significant decrease in enucleations performed due to atrophic bulbi, phthisis bulbi (both conditions involving a shrinking, non-functional eye), and painful blind eyes. Similarly, enucleations resulting from acute trauma also declined. Conversely, there was a marked increase in enucleations due to intraocular tumors, including retinoblastoma and uveal melanoma (a cancer of the uvea, the middle layer of the eye).

  • Malignant tumors are the leading cause of enucleation (73%)
  • Retinoblastoma is the most common malignancy in young patients.
  • Atrophic bulbi/phthisis bulbi and acute trauma-related enucleations are decreasing.
  • Intraocular tumor-related enucleations, like those for retinoblastoma and uveal melanoma, are on the rise.
The study also highlighted the age-related differences in the primary indications for enucleation. Retinoblastoma was the most common cause in young patients (under 20 years old), while atrophic bulbi and phthisis bulbi were more prevalent in middle-aged adults. Uveal melanoma was the leading cause in older adults. These distinctions emphasize the importance of considering age as a critical factor in diagnosing and managing eye conditions.

Implications and Future Directions

The trends identified in this study have significant implications for eye care and public health initiatives. The increasing incidence of enucleations due to intraocular tumors, particularly retinoblastoma and uveal melanoma, underscores the need for heightened awareness, early detection programs, and improved access to specialized treatment. For retinoblastoma, in particular, early diagnosis and prompt intervention are critical for maximizing the chances of survival and vision preservation. The declining rates of enucleation for non-tumor-related conditions, such as atrophic bulbi and acute trauma, suggest improvements in the management and prevention of these conditions. However, continued efforts are needed to further reduce the burden of these eye diseases.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

Everything You Need To Know

1

What is enucleation, and why is it performed?

Enucleation is a surgical procedure involving the removal of the eye. This becomes necessary in end-stage ocular diseases when globe-salvaging treatments are no longer effective. It addresses conditions where the eye is severely damaged or diseased, and its removal becomes the best course of action for the patient's health and well-being. Understanding why enucleation is performed and how the causes evolve is crucial for enhancing eye care and public health strategies.

2

According to the study, what are the primary causes necessitating enucleation in Asian Indian patients?

The study revealed that malignant tumors were the predominant cause, accounting for 73% of cases. Retinoblastoma, a cancer of the retina, was the most common malignancy, particularly in young children. Other notable causes included acute trauma (5%), retinal vascular diseases (3%), and inflammatory/infective pathologies (2%). A substantial portion of cases (23%) fell into a miscellaneous/non-specific diagnosis category.

3

What shifts have been observed in the reasons for enucleation over the past two decades?

Over the 22-year study period, there was a notable decrease in enucleations due to atrophic bulbi, phthisis bulbi (both conditions involving a shrinking, non-functional eye), and painful blind eyes. Similarly, enucleations resulting from acute trauma also declined. Conversely, there was a marked increase in enucleations due to intraocular tumors, including retinoblastoma and uveal melanoma (a cancer of the uvea, the middle layer of the eye).

4

How does age factor into the reasons for needing enucleation?

Age plays a significant role in the primary indications for enucleation. Retinoblastoma was the most common cause in young patients (under 20 years old), while atrophic bulbi and phthisis bulbi were more prevalent in middle-aged adults. Uveal melanoma was the leading cause in older adults. These distinctions underscore the importance of considering age as a critical factor in diagnosing and managing eye conditions.

5

What are the broader implications of the trends observed in enucleation cases, especially concerning retinoblastoma and uveal melanoma?

The increasing incidence of enucleations due to intraocular tumors, particularly retinoblastoma and uveal melanoma, underscores the need for heightened awareness, early detection programs, and improved access to specialized treatment. Early diagnosis and prompt intervention are critical for maximizing the chances of survival and vision preservation, especially for retinoblastoma. The declining rates of enucleation for non-tumor-related conditions, such as atrophic bulbi and acute trauma, suggest improvements in the management and prevention of these conditions, requiring continued efforts to further reduce the burden of these eye diseases.

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