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Phantom Eye Syndrome: Types of Visual Hallucinations and Related Phenomena

Roed Rasmussen, Marie Louise M.D.*†; Prause, Jan U. M.D., D.M.Sc.; Ocularist, Martin Johnson*; Toft, Peter B. M.D., D.M.Sc.*

Ophthalmic Plastic & Reconstructive Surgery: September-October 2009 - Volume 25 - Issue 5 - p 390-393
doi: 10.1097/IOP.0b013e3181b54b06
Original Article

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.

Fifty-one percent of eye-amputated patients have phantom eye syndrome.

*Eye Clinic, 2061, Rigshospitalet, University of Copenhagen; and †Department of Neuroscience and Pharmacology, Section for Eye Pathology, University of Copenhagen, Copenhagen Ø, Denmark

Accepted for publication March 10, 2009.

None of the authors has conflict of interest to disclose.

Supported by grants from private foundations: Kleinsmed Svend Helge Arvid Schroeder and Wife Ketty Lydia Larsen Schrøders Foundation. Agency: Lawyers Kjeld Hjortshøj and Peter Skov Hansen, Skodsborg, Denmark. Grant number: 270479-2266; Merchant Christian Andersen and Wife Ingeborg Andersen, Born Schmidts Foundation. Agency: Thyregod Lawyers, Copenhagen, Denmark. Grant number: 6820 mt/yj; Alfred Hersted and Eli Møllers Foundation. Agency: The Lawyer Hans Ficher-Møller, Copenhagen, Denmark. Grant number: 230 0669; The Danielsens Foundation. Agency: Aase and Ejnar Danielsens Foundation, Lyngby, Denmark. Grant number: 106315; Factory owner Einar Willumsens Foundation. Agency: Hjejle Gersted Mogensen, Copenhagen, Denmark. Grant number: tsp/tsp 800.211; The Danish Eye Research Foundation. Agency: The Danish Eye Research Foundation, Copenhagen, Denmark. Grant number: 270479-2266; The Velux Foundation. Agency: The Velux Foundation, Soeborg, Denmark. Grant number: 270479-2266.

Address correspondence and reprint requests to Marie Louise Roed Rasmussen, M.D., Eye Clinic, 2061, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK 2100 Copenhagen Ø, Denmark. E-mail: dr.roed@gmail.com

©2009The American Society of Opthalmic Plastic and Reconstructive Surgery, Inc.