Prevalence of phantom eye syndrome following eye removal: a systematic review and meta-analysis

PURPOSE: To determine the literature-pooled prevalence of phantom eye syndrome (PES) following eye removal, including phantom vision (PV), phantom pain (PP), or phantom non-visual non-painful (PNVNP) sensations. METHODS: Databases were searched from inception to March 12 2025. A systematic review and meta-analysis of PES prevalence and risk factors was conducted. RESULTS: Seven studies were identified (775 patients). The literature-pooled prevalence of PES, defined as having at least one constitutive symptom, was 58.9% (95% CI [50.4, 66.9], I² = 78%, five studies). The most common constitutive symptom was PV in 35.6% (95% CI [29.5, 42.3], I² = 71.1%, six studies), followed by PP in 26.4% (95% CI [20.8, 32.9], I² = 76.1%, seven studies) and PNVNP in 19.9% (95% CI [7.9, 42.0], I² = 91.2%, six studies) sensations. The pooled prevalence of reporting all three constitutive symptoms simultaneously was 4.8% (95% CI [2.2, 10.1], I² = 67.3%, three studies). Commonly reported risk factors in the literature included mental health comorbidities and preoperative pain, though some studies did not conduct multivariable analysis to control for confounding factors. CONCLUSIONS: Low certainty evidence supports that over 50% of patients may develop at least one constitutive PES symptom. Patients may benefit from PES screening, reassurance, and early treatment of postoperative pain.