This study aimed to investigate the prevalence of anxiety and depression among individuals with ocular prostheses and to identify factors associated with these psychological symptoms. A sample of patients who underwent monocular enucleation and socket implantation participated in the study, responding to digital questionnaires covering demographics, psychosocial factors, and aspects related to their ocular prostheses. Depressive and anxiety symptoms were evaluated using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7), respectively. Optimal scale regression analysis was employed to explore factors linked to psychological symptoms in ocular prosthesis users. Results from 100 valid participants revealed a 51% prevalence of depressive symptoms and a 45% prevalence of anxiety symptoms. The mean PHQ-9 score was 4.91 ± 1.98, and the mean GAD-7 score was 4.99 ± 2.15. Factors such as undergoing right eye enucleation, longer duration of ocular prosthesis use, comfort with prosthesis wearing, and greater satisfaction correlated with milder depressive symptoms. In terms of anxiety, those who used ocular prostheses due to trauma or tumors were affected by more severe symptoms, while individuals who were comfortable with their prosthesis or using alumina-based prostheses reported fewer anxiety symptoms. In conclusion, ocular prosthesis users wrestle with significant challenges of depressive and anxiety symptoms. Factors including age, household registration, economic status, enucleation side, cause of anophthalmos, prosthetic material, and satisfaction and duration of prosthesis use were associated with depressive or anxiety symptoms. Long-term comprehensive care targeting these vulnerable individuals is imperative to alleviate depression and anxiety.