Psychogenic visual disorders in an abused child: a case report

A 17-yr-old female, classified as retarded educable, was found to have uncorrected visual acuity of 20/800 in both eyes, unimproved by a pinhole disc. A low myopic correction determined objectively did not improve her visual acuity. Tangent-screen studies uncovered neurasthenic spiral fields superimposed on hysterical tubular contractions of both eyes. Investigation uncovered a history of child abuse since infancy. To rule out organic lesions of the oculocalcarine visual pathways, the patient was referred for electrodiagnostic evaluation. Her visual evoked responses were found to be normal. With the use of strong suggestion, her visual fields were brought out to normal limits and her visual acuity with correction was improved to 20/20 in each eye. With the cooperation of her school counselor, the patient was referred for psychiatric evaluation and therapy.