Anophthalmos Follow-up

Updated: Aug 06, 2021
  • Author: Nick Mamalis, MD; Chief Editor: Donny W Suh, MD, MBA, FAAP, FACS  more...
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Significant cosmetic deformities are often seen if the anophthalmic orbit is not treated early.

Even after proper treatment using conformers, expanders, or surgical treatment, results are often cosmetically disappointing.

Fitted prostheses are completely immobile.

The eyelids often show significant malformations and are shortened and immobile.

Phantom eye syndrome (PES) is defined as any sensation experienced by a patient with anophthalmia or enucleation and may include phantom pain, phantom sensation, and phantom vision. [48] These sensations may be painful and distressful and may lead to decreased quality of life.

Although rare, a case of conjunctival squamous cell carcinoma in an anophthalmic socket has been reported in the literature. [49] The patient was found to be Human Papillomavirus 16 positive.

Conjunctival cysts in anophthalmic sockets can occur, causing patient discomfort. [50] Cysts may also interfere with implants, prosthetics, and cosmesis. [51]



True anophthalmos is considered a pediatric ocular emergency.

As the growth and development of the bony orbit are dependent on the growth of the globe, the absence of an eye or an extremely microphthalmic eye impedes the proper development of the orbit.

The small bony cavity not only is a cosmetic deformity but also does not allow proper fitting of a prosthesis.

Even with proper early treatment, results are often disappointing in patients with anophthalmos.

Recent neuroimaging studies found that a significant rewiring of the brain occurs in individuals with early-life blindness. In individuals with anophthalmia or early-life blindness, the superior colliculus is recruited for auditory processing. [52]


Patient Education

Inform the child with anophthalmos as well as the family that the treatment of this condition could be a long and complicated one.

Multiple conformers, expanders, and surgical treatments may be necessary to create an adequate-sized orbital cavity for placement of a proper-fitting prosthesis. In addition, multiple eyelid and conjunctival surgeries may be necessary throughout the child's life.

The National Eye Institute (NEI) maintains a Web page with answers to frequently asked questions and links to resources that patients may find helpful.