Phantom pain after eye amputation

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.