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[Ocular deviation as the cause of "psychiatric" problems].
Wei-Yong Wang1, Saskia P A van Hulst-Ginjaar, Johannes M de Nie
1Leids Universitair Medisch Centrum, afd. Oogheelkunde, Leiden.
Atypical headaches and psychiatric symptoms in two patients were misdiagnosed until an eye disorder was found. Strabismus surgery successfully treated the ocular deviation causing their disabling symptoms.
Area of Science:
- Ophthalmology
- Neurology
- Psychiatry
Background:
- Two patients presented with atypical headache and were initially misdiagnosed with psychiatric disorders.
- Both patients had a history of ophthalmic issues, yet their symptoms were attributed to psychological causes.
Observation:
- Patient A experienced disabling headaches, treated unsuccessfully with psychological therapies.
- Patient B reported severe photophobia, nausea, and dizziness, leading to a psychiatric diagnosis and treatment.
Findings:
- Ophthalmological examination revealed an underlying ocular deviation in both patients.
- The ocular deviation was identified as the cause of their complex neurological and psychiatric-like symptoms.
Implications:
- Highlights the critical importance of comprehensive medical and ophthalmic history taking.
- Emphasizes thorough ophthalmological examination to avoid misdiagnosis and psychiatric stigma.
- Suggests strabismus surgery as an effective treatment for symptoms arising from ocular deviation.
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