Phantom eye pain is common after eye removal

A questionnaire was given to patients following eye removal to assess the rate of phantom eye pain (PEP) and patient health-related quality of life (QoL).

Study design

This retrospective questionnaire study looked at health outcomes status following eye removal in patients in France. One hundred eighty-five questionnaires were sent, 115 were returned, and 100 were included in the analysis. Inclusion criteria were age >18 years and eye removal ≥3 months prior. All patients had undergone an examination to ensure a healthy socket before receiving the questionnaire. The Douleur Neuropathique 4 (DN4) was used to assess neuropathic pain.

Outcomes

Within the group, 47% experienced PEP, 30% experienced phantom visions, and 38% experienced phantom sensations. Of the patients with PEP, 38% were diagnosed with neuropathic pain based on the DN4, and 62% experienced the pain at least once a week. In the univariate analysis, preoperative pain, glaucoma, anxiety, and depression were significantly associated with PEP; in the multivariate analysis, only anxiety was significantly associated with PEP.

Limitations

As with any questionnaire study, there is always a potential for bias. Although a thorough socket exam was performed in all patients, it would be reasonable to consider imaging any patient with significant socket pain to ensure that there are no other structural abnormalities (e.g., neuroma).

Clinical significance

This study demonstrated that PEP was experienced by nearly half of patients following eye removal surgery. In addition, postoperative anxiety was significantly associated with PEP. These topics should be addressed with patients prior to surgery and queried about postoperatively.