consequences of eye trauma + can someone cry without eyes?

[itsagameweplay]

hi! first time posting :)

so this doesn't need to be accurate at all since my setting is magical and therefore i could just do whatever.

BUT basically my character needs to sacrifice her eyes to some gods and she does this by making her demon friend pluck them out of her head. since shes human im mostly wondering if this wouldnt straight up kill her/make her bleed out/do something irreversible to her nerves in there?? if it does, maybe just clawing them up would be better (aka stabbing them with a sharp object)?

another question i have is whether or not she would be able to cry without eyes. i googled it and it says that if the tear ducts and lacrimal sack are fine then she would be able to but i feel like those things are like. part of the eyes? also if she WOULD...then would it be bloody tears (which would be cool...)?

sorry for lack of eloquency im not a writer im just an artist who wants to add some story elements to their ocs :)

Comments

[liminaltime]

I read about a woman who gouged out her own eyes when she was high on drugs. She survived and didn't bleed out or have major complications other than the loss of her eyes. The optic nerve would have to be severed, so there'd be inevitable nerve damage. Since these are the nerves that you see through, I'm not sure if it would affect other parts of the body much.

The tear glands are in the skin around the eyes, separate from the eyeballs. As long as they weren't too torn up and damaged, she should still be able to cry. I'm not sure if the tears would be bloody, but if so, the blood would probably stop when the damage fully heals.

[telophase]

You can go whichever direction works for you in this case. My partner has an eye that never developed properly, and the surrounding tissues including the tear ducts are completely normal. However, if the eyes were traumatically/magically removed I can see damage happening to the surrounding tissue, which could lead to aesthetically bloody tears.

[sushiflop]

TBH live your dreams with this, if you want your OC to have bloody tears just say that it's a lifelong symptom of being used as a sacrifice or having her eyes torn out by a demon or whatever you like.

[lilacsigil]

The tear ducts are around the eyes, but they're pretty delicate. People who have eyes surgically removed tend to keep the tear ducts, people who lose their eyes in an accident often don't. So you can have the demon be very accurate and keep the tear ducts, or have them be rough and lose the tear ducts. Blood from the eyes happens with recent trauma so she sure will be having bloody tears until everything heals up.

[juushika]

Not a medical professional, have never lost an eye, but recently did a lot of research for a character who did. TL;DR: Agreed with lilacsigil and general consensus that, given eyes are delicate, plus the fantasy setting, you can just go hog wild with your logic.

But, long version:

Modern eye removals (eviscerations, aka just the cornea, and enucleation aka entire eye) are surprisingly well-documented online, unlike a lot of other medical procedures! This was my favorite resource, TW for graphic images of surgery:

https://eyewiki.aao.org/Evisceration
https://eyewiki.aao.org/Enucleation

The main takeaway IMO for your specific questions would be:

1) This is a good way to see up close eye tissue vs and tear duct/surrounding tissue, to confirm for yourself that a) yes, surgically removed eyes can still cry but b) everything is super close together and the tissue is vulnerable, so a traumatic eye injury/removal could definitely damage the tear duct.

2) Eye surgery is definitely surgical/bloody/icky etc, but surprisingly low-impact and localized. It's not a life-threatening wound in itself, and not actually that bloody. Fantasy traumatic eye injury/removal can be as damaging (it's close to lots of sensory organs, heads/faces bleed a lot) as you reasonably want, or as close to modern medicine (demonic eye removal has the same results as modern surgery because magic!) as you want.

3) Modern eye surgeries use an implant (placed inside the surgically-closed tissue) combined with a prosthetic (to aesthetically mimic the missing eye) or conformer (plastic shell, usually used temporarily until a prosthetic is manufactured) to maintain the eye opening's shape, the eyelid's shape, and allow the prosthetic some directional movement. Without these things, the socket will change over time, shrinking down, with a drooping eyelids (upper and lower) and smaller eye opening.

That same wiki, which is maintained by actual ophthalmologists, might have other even more useful pages for traumatic eye injury! Frex. they have a page on https://eyewiki.aao.org/Bloody_Tears that confirms "History of intraocular surgery, orbital surgery, eyelid surgery, facial surgery lacrimal surgery or sinus surgery" as pertinent history to aka possible cause of bloody tears, in other words: bloody tears could be the result of trauma to/around the eye in the short term or potentially long term.

[itsagameweplay]

oh this is SO helpful!!!! i didnt even know people made wikis for specific medical specialties but its really funny how its called the eyewiki (bit on the nose lol)

pretty interesting to find out that eye surgery isnt THAT bloody....i sort of assumed that having eyes be pulled out from the skull would be reallyyy bad (ive been assuming that all the injuries we see in media are way more likely to kill you than they look) but i guess if youre careful enough its fine? given my situation, i think enucleation is perfect since it seems easier to do for an amateur ophthalmologist + would be easier to draw if i ever decide to depict that!!

for the implants, im just gonna assume she wouldnt have them (setting is sort of d&d-ish so its not modern...i guess they could magic some up but idk if they would even think of them) and would rather wear a blindfold of some sort to cover all that up. her having screwed up eyelids would be a pretty sick reminder too :)

as for the bloody tears bit, ty all for reassuring me that she could either look baller with blood tears or be physically unable to cry no matter how hard she tries (more trauma yippee ^^). this actually reminds me: how do you cry without tears? does your throat just close up and you start hiccuping and whatnot but without all the leakage?

[hamatebones]

There's an large animal rescue I follow that posts its animal surgeries on Youtube, which when I type it up just sounds creepy, but it's interesting to watch the kinds of care large animals need. Eye surgeries are pretty common on that channel, and they're usually able to do them with the animal standing up, under basically heavy-duty sedation and a couple of local nerve blocks.

In animals, they're not super worried about aesthetics. I watched a resection last night -- eyeball present but shrunken and nonfunctional -- and really all they did was cut open both eyelids, remove a little bit of lid tissue, and sew the two lids together. So, leaving the eyeball and the tear ducts intact. Reason #1 to do it that way was to make sure the eyelids didn't eventually curl inward, leading to eyelashes scraping along the eyeball and causing infections further on down the line. They leave a small hole in their closure for the tears to drain from the eye over time, or they can also drain through the nose in that animal.

(DOES your MC get de-eyeballing aftercare? Deep open wounds that close to the brain are like, Hello, infection, please kill me! If there's no cleaning/sewing up of the wound, the scarring is likely to be more intense and affect the tear ducts as well.)

But yes, with enucleations, they remove the whole eye and all its functional apparatus, and sew it completely shut. A healed enucleated horse has a golf-ball-sized dip covered with skin where the eye would be, and no worries about where the tears go from that eye, because there aren't any.

[juushika]

So glad to be helpful! Linking a bunch of pics of actual eye surgeries felt, oh, you know, very hit or miss, but I found this research fascinating and weirdly accessible. IME in researching modern surgical procedures and medical fields, few are this well-documented and made accessible to laypeople; a lot of it is paywalled and/or reference papers by/for professionals. Not so eye removals! I'm grateful for it.

Here's another good resource: https://webeye.ophth.uiowa.edu/eyeforum/cases/279-anophthalmic-socket.htm (especially for seeing post-operative bruising etc, if relevant)

Not all people who lose an eye get implants/use prosthetics, so image sources for "natural" eyelid shape etc after eye removal are out there, but I didn't save any good source because it wasn't relevant to my research.

It looks like tear duct blockages are pretty common, so you'd think crying with limited/no tears would be a thing I could look up, but I'm not finding a dang thing in my search results. Hope you have better results! But that is where I'd start looking.