Enucleation or evisceration of the eye is an uncommon but hugely life-changing surgical procedure for any patient. It may be necessary to remove the eye urgently due to trauma or tumour, or for some patients it may be the end of a long period of treatment and other surgical interventions that leads to removal of a blind, painful eye. No matter what the indications for surgery the care required to support and counsel these patients needs to start well before any surgical intervention. The author will outline and discuss some of the care implications associated with patients who undergo enucleation or evisceration surgery. Being an extensive topic the author has divided the subject into two articles. In this, the first of these articles, the author will discuss the preoperative considerations and in the second part the author will outline the postoperative care. The author works as an oculoplastic specialist nurse and has gained considerable experience in planning and facilitating the care for patients who have to undergo this surgery within a multidisciplinary team setting.