In-Person Visual Anomaly Signs
Every in-person visual Anomaly sign in Animal Hospital — three eyes, hollow eyes, sharp teeth, wide grins and twitching — and how to reject them instantly.
Last updated: June 19, 2026
In-person visual signs are the first and fastest layer of Anomaly detection. These are the tells you can catch with your own eyes the instant a patient steps up to the check-in desk, before you ever touch a camera or take a photo. Because they cost you nothing — no time penalty, no Sanity risk — they should be the very first thing you check on every patient.
The confirmed visual tells
If a patient shows any one of the following, they are an Anomaly. Hit the red Shutter button on the left of your desk to reject them.
Three eyes (or any wrong eye count)
A normal animal has two eyes. A third eye, a missing eye, or eyes in the wrong place is an immediate rejection. Eye count is one of the most reliable tells in the game because it is so unambiguous.
Hollow eyes
Empty, dark, sunken sockets where there should be normal eyes. Hollow eyes also show up as a camera tell, so if you are ever unsure in person, the feed will usually confirm it.
Sharp teeth
Predatory, jagged teeth on a patient that should not have them. A mouth full of sharp fangs is a classic Skinwalker giveaway.
Realistic or human-like teeth
Even more unsettling than sharp teeth — flat, realistic, human-style teeth in an animal’s mouth. If the smile looks like it belongs on a person, reject.
Wide grin
An unnaturally stretched, too-wide grin. Real patients do not beam at you with an exaggerated smile. Combined with realistic teeth, this is an obvious tell.
Twitching
Jittery, broken, or stuttering movement. Healthy patients move smoothly; an Anomaly may twitch or glitch in place. Twitching also appears on the camera feed, so it is a tell you can confirm two ways.
How to use visual signs in your routine
Visual signs are step one of the three-layer detection routine. The discipline is simple: look at every patient first, before doing anything else. If you spot a sign, reject and move on — do not take a photo, because a cursed photo can drain your Sanity and you have no reason to look at one once you are already certain.
If the patient looks completely normal in person, that does not mean they are safe. Many Anomalies are designed to look perfect at the desk and only break on the cameras or in the photo. So a clean visual check simply advances you to step two; it is never a green light to admit on its own.
Avoiding false rejections
The biggest trap with visual signs is the game’s art style. Animal Hospital is deliberately eerie, and plenty of perfectly normal patients look a little off. Resist the urge to reject on atmosphere alone. Reject only when you can point to a specific sign from the list above. Rejecting a genuine patient costs score and cash, so train yourself to ask, “What exactly is wrong?” before you hit the Shutter. If you cannot name the tell, keep checking with the camera and photo layers instead of guessing.
Build the normal baseline
The reason experienced players catch visual signs instantly is that they have a strong mental picture of a normal patient — natural eye count and color, ordinary teeth, smooth movement. Spend your early shifts memorizing that baseline and the anomalies will jump out at you. Once you have visual signs down, layer in the camera anomalies and photo anomalies to cover the patients that pass the eye test, and consult the Tier List to see which missed tells are the most dangerous.
Frequently asked questions
Are visual signs always present on Anomalies?
No. Visual signs are the fastest tell but they are not on every Anomaly. If a patient looks clean in person, move on to the camera check and then the photo check before admitting.
Should I take a photo if I already see a visual sign?
No. If you can already see a visual sign, reject immediately with the Shutter. Taking a photo wastes time and a cursed photo can cost you Sanity for no benefit.
Is a creepy-looking patient always an Anomaly?
Not necessarily — the whole game has an unsettling art style. Only the specific signs listed here (and the camera and photo tells) confirm an Anomaly. Reject on tells, not on vibes.