Phantom Eye Syndrome: Types of Visual Hallucinations and Related Phenomena

PURPOSE: To describe the prevalence of phantom eye syndrome in eye-amputated patients, to give a description of visual hallucinations, and to identify triggers, stoppers, and emotions related to visual hallucinations. METHODS: The hospital database was screened, using surgery codes for patients who had received ocular evisceration, enucleation, or secondary implantation of an orbital implant in the period 1993-2003. A total of 267 patients was found and invited to participate, 173 accepted. Patients who accepted participation had their records reviewed, and a structured interview about visual hallucinations and pain was performed by one trained questioner (M.L.R.R.). RESULTS: The prevalence of phantom eye syndrome was 51%. Elementary visual hallucinations were present in 36%, complex visual hallucinations in only 1%, and other visual hallucinations in 14%. The elementary visual hallucinations were most often white or colored light, as a continuous sharp light or as moving dots. The most frequent triggers were darkness, closing of the eyes, fatigue, and psychological stress; 54% of patients had the experience more than once a week. Ten patients were so visually disturbed that it interfered with their daily life. CONCLUSIONS: Phantom eye syndrome is common, and the authors recommend that surgeons inform their patients about the phenomenon.