Functional Vision Loss Among Adults and Children: Literature Review and Comparative Analysis

The purpose of this study was to compare functional vision loss (FVL) among adults and children, including its presentation and the biopsychosocial factors that may contribute to FVL development.

PubMed, Scopus, and PsycInfo databases were searched in April 2023 for studies reporting data on visual acuity loss (VAL), visual field defects (VFDs), psychiatric disorders, or biopsychosocial stressors of patients with FVL. Studies were excluded if they did not report information on the specific outcomes for all patients or reported on only a subset of FVL patients.

Overall, 27 studies were included, comprising 1,476 patients. Twenty-six articles reported on visual symptoms, 14 on psychiatric disorders, and 11 on biopsychosocial stressors. The prevalence of VAL was similar among adults (80%) compared with children (83%), but VFDs were significantly more common among adults (86% in adults vs. 50% in children). The prevalence of a history of psychiatric disorders was similar among both adults (42%) and children (23%). Adults most commonly reported accidents or physical trauma (31%) as predisposing or precipitating factors for VAL, whereas children most frequently reported family or home stress (19%).

VFDs were found to be more common among adults than among children with FVL. Among adults and children with FVL, different psychiatric and biopsychosocial stressors were reported. This review was limited by the heterogeneous data among studies and unstandardized methods of data collection and reporting. Future research may seek to better understand the differences between adults and children with FVL and explore possible treatment options.