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Medically unexplained visual loss in adult patients
1Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK. p.g.griffiths@ncl.ac.uk
Eye (London, England)
|March 24, 2004
Summary
This study analyzed patients with medically unexplained visual loss (MUVL), finding it predominantly affects females and often involves symptoms like glare or pain. While some visual recovery occurred, it was usually incomplete, highlighting the need for better diagnostic criteria for MUVL.
Area of Science:
- Neuro-ophthalmology
- Visual Science
- Psychosomatic Medicine
Background:
- Medically unexplained symptoms (MUS) are common across medical specialties.
- Ophthalmology's contribution to the study of MUS, particularly visual loss, remains under-investigated.
- Standardizing terminology for nonorganic visual loss is needed.
Purpose of the Study:
- To characterize patients with nonorganic or medically unexplained visual loss (MUVL) presenting to neuro-ophthalmology.
- To identify common features and patterns associated with MUVL.
- To inform diagnostic approaches for MUVL.
Main Methods:
- Retrospective review of 58 MUVL patients with at least 18 months follow-up.
- Inclusion criteria: neuroimaging and other investigations ruled out organic pathology.
- Requirement for at least one inconsistent finding during visual function testing.
Main Results:
- MUVL predominantly affected females (79%).
- 36% of patients had prior unexplained symptoms in other specialties; 60% reported glare or pain.
- Bilateral MUVL often showed symmetrical acuity loss and concentric visual field constriction; unilateral cases were more variable.
Conclusions:
- MUVL represents a significant clinical challenge in neuro-ophthalmology.
- Further research should focus on identifying positive diagnostic markers for MUVL.
- A move away from MUVL being solely a diagnosis of exclusion is recommended.