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Concurrent visual conversion reaction and simulated colour vision defects in a 12-year-old child
N A Barnard1, J Birch, H Wildey
1Department of Optometry and Visual Science, City University, London, UK.
Summary
Visual conversion reaction (VCR), a psychosomatic anomaly, can cause vision problems in children. This case highlights how VCR and malingering can coexist, presenting diagnostic challenges in pediatric vision assessment.
Area of Science:
- Ophthalmology
- Pediatric Psychology
- Psychosomatic Medicine
Background:
- Visual conversion reaction (VCR) is a psychosomatic disorder affecting children, often presenting as reduced vision or visual field defects.
- While malingering (conscious simulation for secondary gain) is less common in children, it can occasionally overlap with VCR.
- Understanding the interplay between functional visual disorders and potential simulation is crucial in pediatric ophthalmology.
Observation:
- A 12-year-old child presented with behavioral and reading difficulties.
- The child exhibited reduced vision, suspected to be linked to VCR.
- Severe color deficiency was also noted, raising suspicion of malingering.
Findings:
- The reduced vision was primarily attributed to Visual Conversion Reaction (VCR).
- The severe color deficiency was best explained by simulation or malingering.
- This case demonstrates the potential coexistence of VCR and conscious simulation in a pediatric patient.
Implications:
- Highlights the diagnostic complexity when functional visual anomalies and malingering present concurrently in children.
- Emphasizes the need for careful evaluation to differentiate between genuine psychosomatic conditions and intentional simulation.
- Informs clinical practice regarding the assessment and management of pediatric vision complaints with potential psychological components.