Functional visual loss in an Israeli pediatric population

Pediatric functional visual loss (FVL) is the loss of vision in a child that cannot be explained by an organic pathology. In the last decade, only a few studies on pediatric FVL have reported long-term patient follow-up.

To report the characteristics of pediatric FVL with long-term follow-up in Israeli children.

We conducted a retrospective chart review of the medical records of patients with FVL from 2000 to 2010. Only children with adequate follow-up (at least 2 months) were included.

Of the 12 patients identified, 9 were females. Mean patient age was 10.5 +/- 4.4 years (range 3.5-17 years). Most children (75%) had bilateral visual loss. One patient had a history of psychiatric illness and in three patients a preceding psychosocial event/trauma was identified. Brain imaging and electrophysiology testing (if done) were normal in all cases. No medications were prescribed to any of the patients,and all were reassured that there was a high chance of spontaneous resolution. The follow-up time was 2-108 months (mean 23.8 months, median 6). During the follow-up period 9 ofthe 12 had complete resolution and 2 had relief of symptoms. Three patients reported a recurrence of symptoms. No organic disease was ever diagnosed in this group.

FVL may occur in all age groups, including children. In cases of visual loss, it is usually bilateral and can involve both acuity and visual field loss. In the present report most of the patients experienced normalization or relief of their symptoms without medical treatment.