ABSTRACT.Purpose: To characterize the quality of phantom pain, its intensity and frequency following eye amputation. Possible triggers and relievers of phantom pain are investigated. Methods: The hospital database was searched using surgery codes for patients who received ocular evisceration, enucleation, orbital exenteration or secondary implantation of an orbital implant in the period between 1993 and 2003. A total of 267 patients were identified and invited to participate; of these, 173 agreed to participate. These patients' medical records were reviewed. A structured interview focusing on pain was conducted by a trained interviewer. Results: Of the 173 patients in the study, 39 experienced phantom pain. The median age of patients who had experienced phantom pain was 45 years (range: 19-88). Follow-up time from eye amputation to participation in the investigation was 4 years (range: 2-46). Phantom pain was reported to be of three different qualities: (i) cutting, penetrating, gnawing or oppressive (n = 19); (ii) radiating, zapping or shooting (n = 8); (iii) superficial burning or stinging (n = 5); or a mixture of these different pain qualities (n = 7). The median intensity on a visual analogue scale, ranging from 0 to 100, was 36 (range: 1-89). One-third of the patients experienced phantom pain every day. Chilliness, windy weather and psychological stress ⁄ fatigue were the most commonly reported triggers for pain. Conclusions: Phantom pain after eye amputation is relatively common. The pain appears to be similar to the phantom pain suffered by limb amputees. Patients should be informed about this potential complication before surgery.

ABSTRACT.Purpose: To evaluate eye-amputated patients' health-related quality of life, perceived stress, self-rated health, job separation because of illness or disability and socioeconomic position. Methods: Patients were recruited from a tertiary referral centre situated in Copenhagen. Inclusion criteria were eye amputation, i.e. evisceration, enucleation, orbital exenteration or secondary implantation of an orbital implant during the period 1996-2003, and participation in a previous investigation (2005). In total, 159 eye-amputated patients were included, and completed a selfadministered questionnaire containing health-related quality of life (SF-36), the perceived stress scale and answered questions about self-rated health, job changes because of illness or disability and socioeconomic status. These results were compared with findings from the Danish Health Interview Survey 2005. Results: The eye-amputated patients had significantly (p < 0.05) lower scores (poorer health) on all SF-36 subscales and more perceived stress compared to the general population. In all, 43.3% of the patients rated their health as excellent or very good compared to 52.1% of the general population. In total, 25% of the study population has retired or changed to a part-time job because of eye disease. The percentage of eye amputated patients, who were divorced or separated, was twice as high as in the general population. Conclusion: The impact of an eye amputation is considerable. The quality of life, perceived stress and self-rated health of many eye-amputated patients are drastically changed. Eye amputation has a marked negative influence on job separation because of illness or disability and on socioeconomic position.

Phantom eye syndrome is common, and the authors recommend that surgeons inform their patients about the phenomenon.

ABSTRACT.Purpose: The aim of this study was to identify the number of eye amputations, and the causative diagnoses, indications for surgery and surgical techniques applied, and to evaluate a possible change in surgical technique in a tertiary referral centre in Denmark. Methods: The hospital database was screened using surgery codes for patients who had undergone bulbar evisceration, enucleation or orbital exenteration in the period 1996-2003. Patient records were reviewed for gender, age, time since surgery, causative diagnosis (the disease process leading to the indication for amputation), indication for eye amputation, type of surgery and whether an implant was applied. Results: A total of 345 patients were identified as having undergone eye amputation during the 8-year period. Indications for eye amputation were: painful blind eye (127); neoplasm (119); infection (42); recent injury (25); disfiguring blind eye (25); prevention of sympathetic ophthalmia (5), and other reasons (2). Surgical procedures included 174 eviscerations, 154 enucleations and 17 orbital exenterations. The mean number of surgeries per year was 43.1. An orbital implant was applied in 168 patients. Conclusions: The most frequent indications for eye amputation were painful blind eye (37%) and neoplasm (34%). During the study period, the annual number of eye amputations was stable, but an increase in bulbar eviscerations was noticed. Orbital implants were used in 33% of patients in 1996 and 67% in 2003.