Condition: Post evisceration socket syndrome (PESS)2018-09-18T13:16:46+00:00

Post evisceration socket syndrome (PESS)

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The best way to figure out whether your specific condition can be treated or not is to give us a call. We can answer any questions you have and help you clarify which treatment options might be suitable for you.

There are different treatment options available for this condition and the most common ones are listed below:

  • Post evisceration socket syndrome
Learn more about treatment options

Post evisceration socket syndrome (PESS)

What is a Post evisceration socket syndrome?

PESS occurs in patients after enucleation or evisceration surgery. Usually any loss of volume is made up with an orbital implant but sometimes PESS develops regardless. Symptoms may include:

  • Deep superior sulcus above the eye
  • Sunken appearance of the eye
  • Blepharoptosis (upper eyelid droop)
  • Lower eyelid droop/ laxity
  • Redness and discharge from the socket
  • Discomfort/ pain
  • The ocular prosthesis may fall out of the socket

PESS syndrome is treated successfully in the majority of the cases.



Examination is very comprehensive, assessing the entire socket, the eyelid position, orbit volume, conjunctival lining etc. The patient’s whole face is also examined.

Before and after an oculoplastic procedure it is common to take photographs.

PESS examination may also include some special measurements such as the palpebral aperture, the elevator muscle function, eyelid laxity etc. Theses are done simply with a light and a ruler. Sometimes a CT scan or MRI of the orbit is required.


Depending on the problem, different treatments are offered:

  • For inflammation of the socket, treatment is usually done with drops and ointment over the course of a few days or weeks. If the prosthesis is old or does not fit properly into the socket it may require a polish or a replacement.
  • For blepharoptosis, you may need a ptosis operation
  • If the main concern is sunken appearance of the prosthesis, we can add some volume into your orbit and periocular area to improve it. This can be done via dermis-fat graft or autologous fat transfer, both conducted under general anaesthetic.
  • If the main problem is eyelid laxity and the prosthesis falling out, it may be necessary to tighten the eyelids. The most common techniques to do this are the lateral tarsal strip and the lateral/medial canthopexy. 



Here’s what they say

“Dr. Jane Olver was fantastic! She was so caring and sweet and it was clear that she knew what she was doing – very professional! I am absolutely over the moon with my results now!”

Toni C.

“Jane Olver is your woman – I wish I had found her at the start. I will be forever grateful for her care and expertise.”

Nancy W.

“Just wanted to thank you for your exceptional assistance with my eye condition. I was so worried but you really helped me feel at ease.”

David T.

“I felt much better after speaking to you and being reassured. I am much calmer and actually got some sleep last night.”

Catherine M.
“I was deeply impressed by the politeness and empathy shown to me. I found the surgery very peaceful and beautifully decorated and I hope to see Jane again soon.”
Jeffrey W.
“I highly recommend Jane Olver. The whole experience was calm and highly professional.”
Lorraine M.
“I am writing to you to say thank you to you, Cloe and Jane for taking care of me this week. You were all really lovely and professional and I am very grateful. Big cheer for The Clinica London Team.”
Rick A.
“Many thanks for taking care of my ptosis surgery today. I am now back home and resting but wanted to send a quick note to thank you for taking such good care of me.”
“The treatment was a great success; within 24 hours of starting the treatment the pain and swelling subsided and as a result, I was able to enjoy a great holiday in Argentina.”
“Thank you, my eye is recovering brilliantly (you almost can’t see I had it). Jane was amazing, please pass on a huge thank you.”

“What I loved most was her willingness to take my knowledge of my disease and experience into consideration. I am very impressed and feel lucky to be in her care.”
Fiona M.
“Dr. Crawley is always in such a good mood and always does her utmost to help. Best doctor I have ever seen!”
Matthew K.
“Dr. Crawley has a wonderful manner, is clearly knowledgeable and is an asset to the hospital.”
Lisa A.
“It was a pleasure to be there, the premises are excellent and the professionalism and care that was extended to me were equally excellent. I can’t fault any part of the process whatsoever and am pleased that the procedure seems to have been successful.”
Rob Swallow
“Thank you for your help during the year.”
Julia S.
“Just a quick note for saying thanks for looking after my Mum so wonderfully as she was very worried about the appointment and you really made such a big difference to the experience.”
Sven K.

“Thank you very much for seeing me yesterday, you were marvellous and a pride to the NHS.”

Mariah P.
“I was treated with great courtesy and kindness, and everything was explained to me in layman’s terms so I could fully understand my condition. I was immensely impressed.”
“Many thanks to Mr Khan. His prompt diagnosis and explanation was very reassuring indeed.”
Heather M.
“Dr Khan and Ingrid both put me at ease, talked me through the procedure, the aftercare, gave general tips/advice for maintaining a healthy/clean eye and were really friendly, whilst being professional throughout.”

“Just keep up the good work Dr. Khan. My wife, who accompanied me, and I were both very impressed by the care and consideration shown by the whole team when I had surgery. The care of this team has made it a wonderful experience for me.”
David S.
“Ever since my first consultation with you, the caring dedication and understanding I have received from you has been priceless. Thank you with all my heart. Wishing you a healthy and happy future.”
Doreen S.
“We left with a much greater understanding of the issues involved with genetic testing. It was also very helpful and reassuring to see Dr. Amar again and be introduced to Jonathan the genetic counselor.”
Rachael S.
“On behalf of my mother as well as myself, I would like to thank you for the consultation we had with you last Friday regarding my Usher Type 2/ RP condition. The knowledge and advice you shared with us was much appreciated.”
Chris B.
“Your caring attitude and honest approach to help relieve my problem and find the best solution is overwhelming. And it is with this in mind we would like to express our sincere thanks for everything you have done for me.”
Maurice K.

“Mr. Reddy was extremely kind and his special ‘duck’ noises certainly helped catch Talia’s attention and helped his examination run smoothly.Everyone involved is really pleased with the results of the surgery, most of all it seems is Talia.”

Rebecca and Daniel Corney


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