Do they take eyes out during autopsy?

During an autopsy, the medical examiner may remove the eyes depending on the circumstances and cause of death. Removing the eyes allows the medical examiner to closely examine them for signs of trauma, disease, or other abnormalities that could help determine the cause of death.

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What is an autopsy?

An autopsy is a thorough medical examination of a body after death that is performed to determine the cause and manner of death. It involves examining the internal organs and tissues of the body for any abnormalities, trauma, or disease processes. An autopsy is usually performed by a medical examiner or coroner.

Why are autopsies performed?

There are a few main reasons why autopsies are performed:

To determine the cause and manner of death – Autopsies help establish how the person died (cause of death) and whether it was due to natural causes, homicide, suicide, accident, or undetermined reasons (manner of death).
For legal investigations – Autopsies are often needed to gather forensic evidence in potential criminal cases such as homicides or suspicious deaths.
For public health statistics – Data collected from autopsies helps identify injury trends, epidemics, and risks to public health.

For medical knowledge – Autopsy findings contribute to medical research and improving understanding of diseases and injuries.
For quality assurance – Autopsies can validate clinical diagnoses and provide feedback on medical care given prior to death.

What is involved in an autopsy?

A complete autopsy involves several detailed steps and processes. These typically include:

External examination – Looking at the external body for any signs of injury, unusual markings, bruises, wounds, abnormalities etc. Measuring and weighing the body are also done.
Toxicology tests – Taking samples of body fluids and tissues to test for substances such as drugs, alcohol, poisons and chemicals.
Examining internal organs – Opening up body cavities to remove, examine and weigh organs. The brain is also examined by removing the top of the skull.

Dissection – Cutting and looking at tissues under magnification for abnormalities and disease.
Microscopic examination – Taking small tissue samples and looking at them under a microscope to help identify diseases.
Chemical analysis – Conducting tests on fluids and tissues to determine chemical makeup.

Documentation – Extensive notes, diagrams, photos and measurements are taken to document findings.

Are the eyes removed during an autopsy?

In many cases, the medical examiner will remove the eyes during an autopsy. There are several reasons why the eyes may need to be taken out and examined closely:

To look for ocular diseases or abnormalities – Diseases like glaucoma, cataracts, retinal detachment can be identified.

To determine the cause of vision loss or blindness – The back of the eye can be checked for changes.
To identify signs of increased pressure in the brain – Swollen optic nerves may indicate increased intracranial pressure.
To look for traumatic injury – The eyes may show hemorrhaging, tearing or other damage from blunt force or gunshot wounds to the head.

Toxicology testing – Chemical analysis of ocular fluid may show presence of toxins, drugs or other substances.
Microscopic examination – The vitreous and aqueous humors of the eye can be tested for microscopic evidence.

However, the eyes may be left in place if there is no specific indication to examine them and the cause of death is readily identified without removing them.

How are the eyes removed?

To remove the eyes during an autopsy, the medical examiner will typically do the following steps:

Make an incision through the skin of the upper and lower eyelids using a scalpel.
Use scissors to cut the conjunctiva, muscles and fatty tissue surrounding the eyeball.

Sever the optic nerve at the back of the eye using scissors.
Remove the eyeball from the eye socket by gently easing it out.
Place each eyeball in a collection jar filled with fixative solution to preserve it.

Examine the eyes later under magnification or send for laboratory testing.

This is done carefully to avoid excessive damage to the eye structure before examination. The remaining empty eye sockets in the body can be filled with cotton balls to retain a natural appearance for funeral services if needed.

How are the removed eyes examined?

The medical examiner has multiple options to closely inspect the removed eyes from an autopsy and determine if there are any abnormalities:

Gross examination – The external eye structures can be visually inspected for hemorrhages, trauma, tumors or other lesions. The intraocular fluids and retina are also checked.
Dissection – The eye can be carefully sliced to view all the internal structures.
Microscopic analysis – Thin slices of eye tissue can be stained and viewed under a microscope to inspect the cells.

Toxicology – The vitreous and aqueous humors can undergo lab testing for chemicals and toxins.
Microbiology – Cultures can be taken to look for pathogenic microorganisms like viruses, bacteria and fungi.
Biochemistry – The ocular fluid can be tested for analytes related to diseases and metabolic disorders.

Specialized ocular pathologists may be consulted if required. The findings help corroborate other autopsy conclusions about cause of death.

Reasons for leaving eyes in place during an autopsy

There are some situations in which the medical examiner may decide not to remove the eyes during an autopsy. Some reasons this may occur include:

An obvious cause of death is quickly identified that does not require analysis of the eyes.

There is extensive damage to the head and eyes from major trauma that renders them nonsalvageable or non-viable for examination.
Decomposition has progressed too far making examination impossible.
Objection from the deceased’s next of kin on religious or cultural grounds.

Conservative autopsy that limits procedures to only what is essential to determine cause of death.
Limited resources, equipment, or specialist availability at the exam facility to properly examine eyes.

However, not removing the eyes can limit the ability to find underlying or contributory factors in the death. The medical examiner has to balance thoroughness against necessity.

What happens to eyes after autopsy examination?

After the eyes are removed and examined, there are a few options for what can be done with them:

They may be returned to the body and placed back into the eye sockets for funeral services and burial.
They can be preserved via fixation and embedding for long-term storage as forensic evidence.

The corneas may be used for transplantation if consent was given and they are eligible.
They are typically incinerated or disposed of as medical waste after examination is complete.

Families can request that removed eyes be returned to the body as long as they do not hamper autopsy conclusions. Otherwise, most facilities follow biohazard protocols for proper disposal.

Can eye removal delay an autopsy?

Removing the eyes does add one additional step to the autopsy procedure. However, it rarely causes a significant delay in completing the autopsy. The eyes are just one set of organs that are removed and examined. An experienced medical examiner can extract and dissect eyes fairly quickly before moving on to other parts of the exam.

The ocular examination itself can be done afterwards outside of the main autopsy. Some specialized testing like microscopic analysis, toxicology and microbiology may take more time but do not hold up the bulk of the autopsy. Unless there is a specific need to rush results, removing the eyes generally does not slow down standard autopsy procedures.

Does eye removal affect an open casket funeral?

If the eyes are removed during an autopsy, it does not preclude having an open casket funeral. The medical examiner will place cotton balls or eye caps in the empty sockets after removing the eyes. These keep the eyelids in their natural position. The mortician can then close the lids when preparing the body for viewing and funeral services. With proper preparation, there should be minimal visible difference in the appearance of the face compared to eyes left in place.

However, certain circumstances like facial trauma may make an open casket challenging. Overall though, the removal itself does not prevent properly restoring the face for a viewing if desired by the family.

Can eye donation still occur after autopsy?

In some situations, eye donation for corneal transplants can still be done even if the eyes were removed during an autopsy. However, it depends on several factors:

How much time elapsed after death before removal and preservation – Eyes need to be recovered shortly after death before decomposition starts.

Whether consent for donation was obtained prior to autopsy.
The integrity of the corneas – They cannot have significant damage or trauma.
Negative autopsy and toxicology results – No infections or hazardous chemical exposure.

If the corneas are eligible based on these criteria, they may be harvested by the medical examiner and sent to an eye bank for evaluation and transplant coordination. However, autopsy and forensic needs take priority over donation wishes. Donation cannot interfere with determining cause of death.

Conclusion

During an autopsy, removing the eyes is a common practice that allows the medical examiner to thoroughly examine them for clues about the cause of death. However, eyes may be left in place if there is no specific need to examine them more closely, or religious/cultural objection. If removed, they do not significantly delay the rest of the autopsy or rule out an open casket funeral. Eye donation may still be possible in some circumstances after autopsy if the corneas are eligible. Overall, the decision to remove the eyes is made on a case-by-case basis weighing what is needed to achieve autopsy objectives.