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Phantom vision after eye removal: prevalence, features and related risk factors
  1. Arnaud Martel1,
  2. Stephanie Baillif1,
  3. Pierre Thomas2,
  4. Fabien Almairac3,
  5. Olivier Galatoire4,
  6. Mehrad Hamedani5,
  7. Denys Fontaine3,
  8. Michel Lanteri-Minet6
  1. 1Ophthalmology, University Hospital Centre Nice, Nice, Provence-Alpes-Côte d’Azur, France
  2. 2Neurology, University Hospital Centre Nice, Nice, Provence-Alpes-Côte d’Azur, France
  3. 3Neurosurgery, University Hospital Centre Nice, Nice, Provence-Alpes-Côte d’Azur, France
  4. 4Oculoplastics, Fondation Rothschild, Paris, Île-de-France, France
  5. 5Hôpital Ophtalmique Jules Gonin, Lausanne, VD, Switzerland
  6. 6Pain Evaluation and Management Department, University Hospital of Nice, Fédération Hospitalo-Universitaire InovPain, Cote d’Azur University, University Hospital Centre Nice, Nice, Provence-Alpes-Côte d’Azur, France
  1. Correspondence to Dr Arnaud Martel, Ophthalmology, University Hospital Centre Nice, Nice, Provence-Alpes-Côte d’Azu, France; arnaudmartel{at}hotmail.fr

Abstract

Aim Phantom eye syndrome is a poorly understood and underestimated complication of eye removal (ER). Seeing with the amputated eye, referred to as phantom vision (PV), is undoubtedly the most intriguing and confusing complication experienced by anophthalmic patients. The aim of the study was to assess PV prevalence, clinical features and risk factors after ER.

Methods A multicentric questionnaire-based study was conducted between April 2016 and July 2017. Patients >18 years who underwent ER >3 months ago had a socket examination before inclusion. Data recorded included patients’ demographics, and preoperative, surgical and postoperative features.

Results One hundred patients (53 men) with a mean age of 65.1 years (29–92; SD=13.0) were included. ER indications were: uveal melanoma (n=24, 24%), trauma (n=20, 20%), retinal detachment (n=20, 20%), glaucoma (n=14, 14%) and endophthalmitis (n=12, 12%). Thirty (30%) patients experienced PV. Elementary and complex visual hallucinations were experienced by 80% and 20% of patients, respectively. PV usually appeared within the first postoperative month and tended to decrease over time. Risk factors for PV were the preoperative use of proton beam therapy (p=0.006), uveal melanoma (p=0.014), enucleation (p=0.015), anxiety with a Hospital and Anxiety Depression (HAD) score ≥8 (p=0.042), depression with a HAD score ≥8 (p=0.030), phantom eye pain (p=0.044) and phantom eye sensations (p=0.002).

Conclusion PV was reported by one-third of our patients. Despite being widely misunderstood, ophthalmologists and neurologists should be aware of this complication to adequately reassure patients.

  • orbit
  • visual perception
  • treatment surgery

Data availability statement

No data are available. none.

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Data availability statement

No data are available. none.

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Footnotes

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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