• Oculoplastics/Orbit

    Review of: Phantom vision after eye removal: Prevalence, features and related risk factors

    Martell A, Baillif S, Thomas P, et al. British Journal of Ophthalmology, November 2022

    As phantom vision (PV) can have profound effects on patients, investigators aimed to determine the prevalence of and risk factors for PV following eye removal.

    Study design

    This multicenter study included 100 adult patients who underwent eye removal >3 months before participating in the study. A questionnaire was given to the patients to assess the presence of phantom vision (PV) postoperatively. Phantom vision was defined as any vision occurring without visual stimulation of the amputated eye, and was further divided into elementary vision (e.g., lightning, black dots, colors) or complex visions (e.g., faces, objects, landscapes).

    Outcomes

    Thirty percent of patients reported PV, with almost half of this group reporting PV within the first month after surgery. However, in general PV improved with time. Eighty percent of patients reported elementary hallucinations and 20% reported complex visual hallucinations. Risk factors for developing PV included the preoperative use of proton beam therapy, uveal melanoma, enucleation, anxiety and depression, and concomitant phantom eye pain or phantom eye sensations.

    Limitations

    This study has the inherent weaknesses of a survey study; i.e., the investigators were dependent on subjective reporting from patients.

    Clinical significance

    Phantom vision is a relatively common experience after eye removal. Patients should be counseled preoperatively about the possibility of this occurring, and that if it happens it will likely improve with time.