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When the eye has to be removed with the maxilla | CION Cancer Clinics
During a maxillectomy, the eye is removed only when the cancer has grown through the lining of the eye socket. When the cancer has reached the bone under the eye but not that lining, the eye is usually kept and its floor rebuilt. This page explains how that decision is made, what removing the eye involves, and what life with one eye is really like. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- When does the eye have to be removed during a maxillectomy?
- What can be done for the eye in this operation?
- What happens before and after the eye is removed?
- What do families often believe about losing an eye?
- What is life like with one eye?
- What do the eye-related words in your report mean?
- What should you ask before agreeing to the plan?
- Common questions about the eye and maxillectomy
The short answer
When does the eye have to be removed during a maxillectomy?
The eye is removed only when the cancer has grown through the thin lining around the eye socket and into the fat, muscles or eye itself. If the cancer has touched the bone under the eye but not passed through that lining, the eye can usually be kept.
What the lining is
The eye sits in a bony socket called the orbit. Inside the bone, a tough lining called the periorbita wraps around the eye, its muscles and fat. It acts as a barrier. Cancers of the maxillary sinus often push against it from below, and whether they have broken through decides what happens to the eye.
The name you may hear
Removing the eye along with the contents of the socket is called orbital exenteration. It is different from removing only the eyeball. Your surgeon will explain which one, if either, is being considered for you.
Scans can suggest whether the lining has been breached, but sometimes this is only certain during the operation. Ask how that decision will be made on the day.The possibilities
What can be done for the eye in this operation?
There are several possible outcomes for the eye. Which one applies depends on how far the cancer has reached.
Eye kept, socket floor intact
The cancer is below the eye socket. The floor under the eye is not touched, and the eye stays exactly where it is.
Eye kept, socket floor rebuilt
The bone under the eye is removed but the lining is clear. The floor is rebuilt so the eye does not sink.
Rebuilt with
- Thin titanium mesh
- Bone or tissue from elsewhere in the body
Eye and socket contents removed
The cancer has entered the socket. The eye, its muscles and fat are removed together. The eyelids are kept when the cancer allows.
Socket closed or lined
After removal, the socket is either filled with a flap of tissue or lined with a thin skin graft so that an artificial eye can be fitted later.
Not sure whether this applies to you?
Ask an oncologistStep by step
What happens before and after the eye is removed?
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An MRI and an eye examination
The MRI shows how close the cancer is to the eye. An eye specialist checks your vision in both eyes, which matters for planning life with one.
-
A frank conversation
The surgeon explains why the eye is at risk and what the other choices are. Bring the family member who will support you. Ask for time if you need it.
-
The operation
The eye is removed in the same sitting as the maxillectomy, and the socket is closed or lined. You wake with a firm dressing over the area.
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Healing of the socket
The socket takes weeks to settle. Radiotherapy, if planned, usually comes during this period and can slow healing.
-
An artificial eye, if you choose one
Once healed, a specialist can make an orbital prosthesis, an artificial eye with surrounding skin, held by glasses, glue or small implants. Some people prefer a simple eye patch.
Commonly believed
What do families often believe about losing an eye?
"If the cancer is near the eye, the eye always goes."
Being near is not enough. Many cancers that touch the bone under the eye are removed with the eye kept, because the lining around it has held. The decision rests on whether the cancer has passed through.
"We can keep the eye and treat the rest with radiation."
Sometimes radiotherapy is offered instead of surgery, and that is a real option to discuss. Leaving cancer inside the socket while removing the rest is not usually a safe middle path. Ask your team to explain each choice.
"With one eye, she will not be able to live alone."
Most people adjust to seeing with one eye and go back to cooking, reading, working and moving about the house. Judging distance is harder at first. It improves with time and practice.
"An artificial eye will be able to see."
An orbital prosthesis restores appearance, not sight. It does not move with the other eye. Knowing this beforehand avoids disappointment later.
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Afterwards
What is life like with one eye?
Most people find daily life manageable within a few months. The biggest change is in judging depth, such as pouring tea, climbing stairs or stepping off a kerb.
Practical changes
You will turn your head more to see on the side of the missing eye. Put frequently used things on your seeing side. Take stairs slowly and use the handrail at first. Protect the remaining eye with glasses when working with tools or outdoors in dust.
Driving and work
Whether you can drive again depends on the rules for your licence and on your remaining vision. Ask your eye specialist, and do not assume. Many jobs can be continued with small adjustments.
The feelings are real
Losing an eye can bring grief, even when you know it was needed. Some people avoid mirrors or visitors at first. A counsellor can help, and so can meeting the prosthesis specialist early. Family members often feel it too. Talking openly about the change at home usually makes the first weeks easier for everyone, including the person who has had the operation.
On your report
What do the eye-related words in your report mean?
- Orbit
- The bony socket that holds the eye.
- Periorbita
- The tough lining inside the socket that wraps the eye, its muscles and fat.
- Orbital exenteration
- Removal of the eye together with the muscles, fat and other contents of the socket.
- Enucleation
- Removal of the eyeball only, leaving the muscles and socket contents.
- Double vision
- Seeing two images. It can happen when the eye is kept but its support changes, and often settles or can be corrected.
Being straight with you
What should you ask before agreeing to the plan?
This page cannot tell you whether your eye can be kept. That depends on your scans, and sometimes on what the surgeon finds during the operation. It is a decision for you and your team together.
What the team weighs
They weigh how far the cancer has spread, how well you see with the other eye, whether radiotherapy is planned, and what other treatments could offer. For some people, surgery that removes the eye is not offered at all, for instance when the cancer has spread widely.
Questions to ask
Ask what the scans show about the lining. Ask whether the plan could change during the operation, and who will decide. Ask about other treatment options and what each involves. Ask who will make an artificial eye, and when.
Questions we are asked
Common questions about the eye and maxillectomy
Can the eye be saved if the cancer is close to it?
Often, yes. If the cancer has reached the bone under the eye but not the lining inside the socket, the eye is usually kept and its floor rebuilt. Your surgeon will explain what the MRI shows and how certain that picture is.
Will the eye droop if it is kept?
It can sit lower if its floor is removed and not well supported. That is why the floor is rebuilt with mesh, bone or a flap. Some people notice double vision at first, which often settles. Tell your team if it does not.
Will I see normally after the eye is kept?
Usually, but not always. Swelling, a change in the eye's position and radiotherapy near the eye can affect vision or cause dryness and watering. An eye specialist should check you after surgery and during follow-up.
Does removing the eye hurt more than the rest of the operation?
Most people describe pressure and soreness around the socket rather than severe pain. You are given regular pain relief in hospital and for home. Tell the nurses if it is not controlled, because it can nearly always be improved.
How long before I can get an artificial eye?
The socket must heal fully first, and longer if radiotherapy is given. This often takes several months. Meeting the prosthesis specialist before surgery or soon after helps you know what to expect and plan around it.
Will the eyelids be removed too?
Only if the cancer has reached them. When the eyelids can be kept, they help line the socket and it may heal faster. When they must be removed, the socket is usually filled with a flap or lined with a skin graft.
How do I tell my family or children?
Simply and honestly. Say the eye is being removed to take out the illness. Children cope better with a plain explanation than with silence. An eye patch or glasses at first can make visits easier. A counsellor can help you plan the conversation.
Is an orbital prosthesis covered by insurance?
Cover varies a lot. The cancer operation is often covered under Aarogyasri, CGHS, ECHS, EHS and most cashless insurance plans. The artificial eye may be treated separately. Call the helpline with your card details to check before surgery.
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Sources
- Cancer Research UK — Surgery for nasal and sinus cancer
- National Cancer Institute — Paranasal Sinus and Nasal Cavity Cancer Treatment (PDQ) - Patient Version
- American Cancer Society — Nasal Cavity and Paranasal Sinus Cancer
- Macmillan Cancer Support — Head and neck cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Eye Position and Vision After MaxillectomyWhen the eye is kept, what to watch forPartial, Total and Extended MaxillectomyWhere eye removal fits among the typesFacial Appearance and Cheek Support After MaxillectomyHow the face changes, and what helpsThe Emotional Side of Cancer SurgeryGrief and adjustment after a visible change
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