Conversion visual loss: a differential diagnosis in infant amblyopia.
OBJECTIVE
To report the first case of amblyopia due to a conversion disorder in a child.


METHODS
A 9-year-old girl without allergies or family or personal antecedents of interest presented to our clinic. She manifested a progressive visual loss after an episode of lumbar pain. This progressive loss led the patient in a 6-month period to legal bilateral blindness: visual acuity inferior to 2/20 in both eyes and severe constriction of both visual fields.


RESULTS
Several pathologic processes were discarded by means of multiple explorations and a general multidisciplinary analysis: physical pathology, simulating patient, schizophrenia, and the Briquet syndrome. Finally, she was diagnosed with a conversion somatoform disorder leading to a bilateral blindness. For 6 months, the patient was successfully treated with psychotherapy and a pharmacologic protocol. Total recovery was achieved with final visual acuity of 20/20 in both eyes and normal visual fields.


CONCLUSIONS
Conversion disorders should be considered as an additional etiology of visual loss in children. In these cases, the analysis and multidisciplinary treatment is crucial for a successful outcome.
Laria
Carlos
C
Instituto Oftalmológico de Alicante, VISSUM, Alicante, Spain. Laria1@telefonica.net
Perez
Maria Elena
ME
Perez
Eduardo
E
Pinero
David Pablo
DP
Ruiz-Moreno
José Maria
JM
Aliò
Jorge L
JL
D000550:Amblyopia / Q000209:etiology* / Q000503:physiopathology; D001766:Blindness / Q000209:etiology* / Q000503:physiopathology; D002648:Child; D003291:Conversion Disorder / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D004359:Drug Therapy, Combination; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008140:Lorazepam / Q000031:analogs & derivatives / Q000627:therapeutic use; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology
D005473:Fluoxetine; D006993:Hypnotics and Sedatives; D008140:Lorazepam; D017367:Selective Serotonin Reuptake Inhibitors; C023842:lormetazepam