Similar etiologies of functional visual loss observed in children and adults.
OBJECTIVE
To describe four cases of functional visual loss which challenge the theory that its causes are different in children and adults (i.e., that financial gain is the primary cause in adults while in children it is an involuntary response to psychosocial problems). Rather, we will show a similar etiology of functional visual loss in children and adults. We also describe diagnostic testing and therapeutic approaches that are useful in both children and adults with functional visual loss.


METHODS
Two children (5 and 15 years old) and two adults (54 and 73 years old) with presumed functional visual loss and whose visual functions were assessed with verbal assurance, Starlight Test, Flicker Test, and trial glasses or contact lenses.


RESULTS
Normal visual function was elicited in all four cases. In both pediatric patients we were able to elicit normal vision using verbal assurance and trial glasses or contact lenses. In both adult patients, we elicited dramatic improvements in vision with verbal assurance and discussion of the patients' psychosocial situation.


CONCLUSIONS
Children and adults present with similar etiologies (psychosocial problems) of functional visual loss. In these cases we believe the children were motivated by their desire to wear glasses or contacts and the adults were involuntarily responding to psychosocial problems. These cases show that we cannot, as has been proposed, clearly categorize patients with functional visual loss based upon age.
Hirai
Toshie
T
Department of Ophthalmology, School of Medicine, Nagoya University, Nagoya, Japan. hiraito@asu.aasa.ac.jp
Sato
Miho
M
Kachi
Shu
S
Takai
Yoshiko
Y
Tsuzuki
Kinichi
K
Yoshida
Masakazu
M
Miyake
Yozo
Y
D000293:Adolescent; D000368:Aged; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008306:Malingering / Q000523:psychology; D008875:Middle Aged; D013315:Stress, Psychological / Q000523:psychology; D014786:Vision Disorders / Q000523:psychology*; D014787:Vision Tests; D014792:Visual Acuity