The removal of the entire contents of the orbit, including the eyeballs and eyelids, is usually performed in:

Appeared in: DSSSB 12 August 2024

Explanation

Exenteration is defined as the surgical removal of the entire contents of the orbit.
This radical procedure includes the eyeball, extraocular muscles, fat, nerves, and surrounding soft tissue.
Crucially, the definition includes the removal of 'most or all of the eyelids,' which directly matches the question's description.
It is primarily indicated for life-threatening malignancies that have invaded the orbit, where less radical surgeries would be insufficient.

Option A: Enucleation is the removal of the eyeball (globe) only, leaving the orbital contents like muscles and the eyelids intact.
Option B: Fenestration is a surgical procedure to create an opening or 'window' in a part of the body, typically bone. It is not a removal procedure for the eye.
Option D: Decortication is the surgical removal of the surface layer or fibrous covering of an organ.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Surgical Procedures of the Orbit as background academic context rather than a clinical decision trigger.
Understanding the distinction between these procedures is vital for nurses to provide appropriate pre-operative and post-operative care, which varies significantly based on the extent of surgery.
Exenteration is a physically and emotionally devastating procedure. Nursing care must focus heavily on psychological support, pain management, wound care for the large orbital defect, and patient education regarding facial prosthetics.
A key nursing role is to help the patient cope with the significant change in body image and the loss of binocular vision (depth perception).

How to Approach the Question

First, break down the question's key terms: 'removal', 'entire contents of the orbit', and 'including...eyelids'.
Recognize that the inclusion of 'eyelids' points to the most extensive and radical form of orbital surgery.
Mentally define or recall the definitions of the surgical terms provided in the options.
Compare the definitions. Enucleation is the removal of the eye only. Fenestration and Decortication are incorrect types of procedures for this context.
Conclude that Exenteration is the only term that matches the description of removing all orbital contents plus the eyelids.

Concept Tested & Keywords

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E6 Nursing Brunner Adult Health 3SA Vol 2 Part 1 p. 114-116

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