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[Munchausen syndrome in a child]
1Department of Ophthalmology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China.
[Zhonghua Yan Ke Za Zhi] Chinese Journal of Ophthalmology
|August 3, 2021
Summary
A child presented with eye secretions due to self-inserted foreign bodies, a manifestation of Munchausen syndrome. Improved family dynamics and symptomatic treatment resolved the pediatric ophthalmology case.
Area of Science:
- Pediatric Ophthalmology
- Child Psychiatry
- Psychosomatic Medicine
Background:
- A six-and-a-half-year-old girl presented with persistent white eye secretions unresponsive to prior treatments.
- Initial examination revealed conjunctival congestion, with preliminary diagnoses including conjunctivitis and foreign bodies.
Observation:
- The child exhibited resistance to examination and communication.
- Parents provided photographic and specimen evidence of white secretions.
- Close observation and improved communication facilitated the child's disclosure.
Findings:
- The child admitted to inserting tissue fragments into her eyes intentionally.
- The behavior was identified as a manifestation of Munchausen syndrome by proxy, aimed at gaining parental attention.
- Psychiatric evaluation confirmed Munchausen syndrome.
Implications:
- Highlights the importance of considering psychosomatic causes in pediatric eye conditions, especially with atypical presentations.
- Emphasizes the role of thorough history taking, parental communication, and psychiatric consultation in diagnosing factitious disorders.
- Successful management involved symptomatic eye treatment and addressing underlying family environmental factors.
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