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Psychogenic visual disorders in an abused child: a case report
American Journal of Optometry and Physiological Optics
|October 1, 1978
Summary
Severe vision loss in a teenager with a history of abuse was diagnosed as functional visual impairment. Prompt psychiatric intervention and suggestion therapy successfully restored her sight to normal levels.
Area of Science:
- Ophthalmology
- Psychiatry
- Neuroscience
Background:
- A 17-year-old female with severe visual impairment (20/800) presented with functional visual deficits.
- She had a history of child abuse since infancy, raising concerns for potential organic lesions.
Observation:
- Tangent-screen studies revealed neurasthenic spiral fields and hysterical tubular contractions.
- Electrodiagnostic evaluation, including visual evoked responses, showed normal results, ruling out organic pathology.
- The patient's severe visual impairment was unresponsive to standard optical corrections.
Findings:
- Functional visual impairment was diagnosed, characterized by severe reduction in visual acuity and abnormal visual fields.
- Therapeutic suggestion significantly improved visual fields to normal limits.
- Visual acuity improved to 20/20 in both eyes with corrective lenses after suggestion therapy.
Implications:
- This case highlights the impact of psychological trauma on visual function.
- Functional visual disorders can mimic organic pathology and require a multidisciplinary approach.
- Psychiatric evaluation and therapy are crucial for managing functional visual impairments, especially in patients with a history of abuse.