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Quality of life with anophthalmia: a systematic review

In brief

More than half of eye-removal patients report lasting vision-specific deficits

A review of 42 studies involving 4,544 adults found that while overall health quality improves after surgery, vision-related quality of life stays significantly reduced, especially for depth perception, peripheral vision, and driving. Although average anxiety and depression scores are normal, a notable minority continue to suffer psychological distress, underscoring the need for proactive counseling and multidisciplinary rehab.

Journal
Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation (Q1)
Published
23 July 2026
Study design
Systematic review / meta-analysis of RCTs
Evidence level
Level 1, High (CEBM 1a)
Authors
Abdelrahman Abu Osba, Aaryamaan Verma, Asim Ibrahim, Abd El Aziz Hendy, Mostafa Bondok, Alexander Deans, et al.
PMID
42493695
DOI
10.1007/s11136-026-04343-4

Why clinicians should know about it

  • Picked for Family Practice (top studies of the week, 26 July 2026).
  • Picked for Pediatrics and Child Health (top studies of the week, 26 July 2026): Recent Pediatrics and Child Health research from a high-quartile journal
  • Picked for Ophthalmology (top studies of the week, 26 July 2026): Anophthalmia impacts quality of life, systematic review of outcomes
  • Picked for Psychiatry and Mental Health (top studies of the week, 26 July 2026).

Abstract

PURPOSE: Anophthalmia due to enucleation, evisceration, or exenteration, results in permanent vision loss that may have profound functional, psychological, and social consequences. The purpose of this study is to evaluate health-related quality of life, vision-related quality of life, and psychosocial outcomes among adults with anophthalmia. METHODS: This systematic review was conducted in accordance with PRISMA 2020 guidelines and prospectively registered on PROSPERO (ID: CRD420251274476). MEDLINE, Embase, and CENTRAL were searched from inception to September 9, 2025. Eligible studies included participants with congenital or acquired anophthalmia and reported outcomes related to quality of life or psychosocial health. Risk of bias was assessed using the Cochrane RoB-2 tool for randomized trials and Joanna Briggs Institute critical appraisal tools for observational studies and results were synthesized narratively. RESULTS: Forty-two studies (1999-2025) including 4544 patients (56.0% male; mean age 49.9 years) were included. Enucleation was the most common procedure (55.1%), and most cases were unilateral (59.6%). Health-related quality of life was commonly assessed using the SF-36 and vision-related quality of life using the NEI VFQ-25. Early postoperative reductions in health-related quality of life were frequently observed, with partial recovery over time. Vision-related quality of life remained persistently impaired, particularly for depth perception, peripheral vision, and driving. While mean anxiety and depression scores were often within normal ranges, a substantial subset of patients experienced ongoing psychological distress and appearance-related concerns. CONCLUSIONS: Acquired anophthalmia is associated with enduring vision-specific and psychosocial challenges, supporting the need for anticipatory counseling and integrated multidisciplinary rehabilitation in clinical practice.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.