title: Phantom Eye Syndrome: Patient Experiences after Enucleation for Uveal Melanoma.
abstract: OBJECTIVE
  Patients undergoing enucleation for uveal melanoma need to be informed of the possibility of phantom eye syndrome (PES). The number with uveal melanoma in PES studies has been small. Aims were to: (1) determine the prevalence, symptoms, and characteristics of PES and to test associations of PES symptoms with sociodemographic and clinical characteristics; (2) examine the interrelatedness of PES symptoms; and (3) explore the emotional valence of PES and the relationship to anxiety and depression.
  
  
  METHODS
  Cross-sectional questionnaire.
  
  
  METHODS
  Patients (n = 179) with uveal melanoma enucleated 4 to 52 months previously.
  
  
  METHODS
  Questionnaire on PES. Responses to a routine audit of mood obtained from clinical records.
  
  
  METHODS
  Patients were asked about 3 symptoms: pain, visual sensations, and a feeling of seeing through the removed eye. Mood was assessed by the Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  Of 179 respondents, 108 (60.3%) experienced symptoms: 86 reported (48%) visual sensations, 50 reported (28%) seeing, and 42 reported (23%) pain; 14 (7.8%) reported all 3 symptoms. At the time of the questionnaire, 31 (17%) experienced 1 or more symptoms daily. Women were more likely to report pain (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.08-4.40). Younger patients at enucleation were more likely to report pain (t = 4.13; degrees of freedom (df), 177; P < 0.001) and visual sensations (t = 2.11; df, 177; P < 0.05). Patients studied sooner after enucleation were more likely to report seeing (Mann-Whitney U, 2343; P < 0.05). Pain and seeing were intercorrelated (chi-square, 5.47; Φ = 0.18; df, 1; P < 0.05), pain with visual sensations (chi-square, 3.91; Φ = 0.15; df, 1; P < 0.05) and seeing with visual sensations (chi-square, 34.22; Φ = 0.45; df, 1; P < 0.001). Twenty of 108 patients (18.5%) found symptoms disturbing, and 21 of 108 (19.4%) pleasurable. Patients reporting pain were more anxious (OR, 3.53; 95% CI, 1.38-9.03) and depressed (OR, 13.26; 95% CI, 3.87-46.21).
  
  
  CONCLUSIONS
  Patients should be informed of PES symptoms. Pain may indicate anxiety or depression; this needs research to determine cause and effect.
authors.affiliation: Institute of Psychology, Health & Society, University of Liverpool, Liverpool, United Kingdom; Liverpool Ocular Oncology Centre, Royal Liverpool and Broadgreen University Hospital, NHS Trust, Liverpool, United Kingdom. Electronic address: ldhs@liverpool.ac.uk.
authors.forename: Laura
authors.initials: L
authors.lastname: Hope-Stone
authors.affiliation: Institute of Psychology, Health & Society, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Brown
authors.affiliation: Liverpool Ocular Oncology Centre, Royal Liverpool and Broadgreen University Hospital, NHS Trust, Liverpool, United Kingdom.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Heimann
authors.affiliation: Liverpool Ocular Oncology Centre, Royal Liverpool and Broadgreen University Hospital, NHS Trust, Liverpool, United Kingdom; Ocular Oncology Service, University of California, San Francisco, San Francisco, California.
authors.forename: Bertil
authors.initials: B
authors.lastname: Damato
authors.affiliation: Institute of Psychology, Health & Society, University of Liverpool, Liverpool, United Kingdom.
authors.forename: Peter
authors.initials: P
authors.lastname: Salmon
mesh_terms: D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000523:psychology / Q000601:surgery*; D008875:Middle Aged; D058748:Pain Perception; D010591:Phantom Limb / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D015995:Prevalence; D012678:Sensation Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D013577:Syndrome; D014604:Uveal Neoplasms / Q000523:psychology / Q000601:surgery*; D014792:Visual Acuity; D000098943:Uveal Melanoma