[A case report illustrating the effectiveness of reading performance assessments in the diagnosis and treatment of psychogenic visual disturbances].
OBJECTIVE
An optimal strategy for treating psychogenic visual disturbances in adults has not been established. We report a patient with psychogenic visual disturbances who recovered his visual acuity and showed an improvement in his reading performance after undergoing training based on a reading performance assessment.


METHODS
A 37-year-old man who had been diagnosed as having myopic macular degeneration was referred to our clinic. Three months after his initial diagnosis, no changes in his fundi were observed, but his visual acuity had significantly decreased and his peripheral field of vision had become severely restricted. In view of his tunnel vision, the discrepancy among the visual acuity results obtained by different test methods, the results of a reading assessment, objective eye examination data, and his behavioral patterns, we diagnosed a psychogenic visual disturbance in the patient and referred him to an ophthalmologist and a psychiatrist for follow-up care. In our low vision clinic, we assessed his visual function, including reading performance, and developed a training program including reading, writing, and computer skills. We also provided information to help the patient find a job. The training program included instructions on how to manipulate reading aids and how to select reading materials to maximize his vision; these instructions were effective. Nine months after his rapid decrease in visual acuity, the results of his visual function tests showed an improvement. The patient also became motivated to find a job.


CONCLUSIONS
Reading assessments are a useful tool for diagnosing psychogenic visual disturbances in adults and for coping with functional vision impairment.
Nishiwaki
Yuki
Y
Department of Ophthalmology, Kyorin University School of Medicine, Kyorin Eye Center, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan. nishiwaki@eye-center.org
Tanaka
Etsuko
E
Hirakata
Akito
A
Oda
Koichi
K
Kigasawa
Kazuteru
K
Hida
Tetsuo
T
D000328:Adult; D006801:Humans; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D011602:Psychophysiologic Disorders / Q000150:complications*; D011932:Reading; D012682:Sensory Aids; D014786:Vision Disorders / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*