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[Acute concomitant esotropia and hysterical amblyopia].
M I Pérez-Flores1, M Fernández-Fernández, J Lorenzo-Carrero
1Servicio de Oftalmología, Hospital POVISA, Pontevedra, España. mari-nes@eresmas.net
Archivos De La Sociedad Espanola De Oftalmologia
|October 26, 2005
Summary
This case report details a pregnant woman who developed acute concomitant esotropia and functional vision loss. Neurologic causes were excluded, leading to a diagnosis of hysterical neurosis.
Area of Science:
- Ophthalmology
- Neuro-ophthalmology
Background:
- Acute concomitant esotropia can present without a clear cause.
- Associated factors include fusion disruption, myopia, neurological issues, or decompensated phoria.
- Debilitating physical or emotional illness may precede onset.
Observation:
- A 26-year-old pregnant woman (29 weeks gestation) presented with intermittent esotropia and diplopia.
- Symptoms progressed to include visual loss and accommodative spasm unresponsive to cycloplegia and refraction.
- The condition persisted unchanged for two years.
Findings:
- Neurological causes for the esotropia were excluded.
- The patient was diagnosed with hysterical neurosis, leading to acute concomitant esotropia.
- Hysterical amblyopia or functional visual loss was identified as the cause of reduced vision.
Implications:
- This case underscores that acute concomitant esotropia can be a manifestation of functional visual loss without an organic neurological basis.
- It highlights the importance of considering psychiatric and functional disorders in the differential diagnosis of acute-onset strabismus and visual disturbances.
- The diagnosis of hysterical neurosis and associated functional visual loss provides insight into non-organic causes of ophthalmological symptoms.