How do ophthalmologists manage functional visual symptoms? A UK survey of ophthalmologists’ experience

Laginaf, Masara; Costello, Harry; Price, Gary

doi:10.1007/s00417-021-05433-4

Cited by 7 publications

(4 citation statements)

References 17 publications

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“…Further studies are warranted to determine the level of knowledge referring optometrists have regarding availability and signposting of emotional support services. The lack of signposting is also seen at secondary and tertiary care level, with one study reporting that only 17% of patients were referred by ophthalmologists for mental health services, and only 35% of ophthalmologists stating that they did not struggle with the discussion of psychiatric/psychological problems [21], suggesting that further training may also be warranted in this group of secondary healthcare professionals. Further studies could assess the success of interventional studies that signpost potential low-vision patients to sources of mental health support if needed.…”

Section: Emotional Trauma Of Diagnosis For the Patient And Familymentioning

confidence: 99%

Mental health support across the sight loss pathway: a qualitative exploration of eye care patients, optometrists, and ECLOs

Trott

Driscoll

Bourne

et al. 2023

Eye

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Background The process of becoming visually impaired or blind is undoubtedly a highly emotional experience, requiring practical and psychological support. Information on mental health support provision in the UK across the sight-loss pathway, however, is largely unknown, especially amongst healthcare practitioners that are often sought after for advice: the referring optometrist and eye clinic liaison officer (ECLO). This study aims to ascertain the perceived accessibility and quality of mental health support across the sight-loss pathway. Methods Semi-structured individual interviews were conducted with patients with a diagnosed eye condition who had received care from a hospital eye service, referring optometrists, and ECLOs. Following interview transcription, results were synthesised in a narrative analysis. Results A total of 28 participants were included in the analysis, of which 17 were participants with various eye conditions, five were referring optometrists, and five were ECLOs. After analysis, three broad themes emerged: (1) The emotional trauma of diagnosis (2) Availability of mental health support; (3) The point where mental health support is most needed across the sight-loss pathway. Several patients reporting that they had received no offer of support nor were they signposted to any possible sources. Referring optometrists and ECLO’s agreed. Conclusion It is important that referring optometrists are aware of the need for mental health support services and can signpost to local support services including the third sector anytime during the referral process. Future large-scale, UK-wide research into referral practice and signposting for mental health support for patients is warranted, to identify how services can be improved in order to ensure that the wellbeing of patients is maintained.

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Section: Emotional Trauma Of Diagnosis For the Patient And Familymentioning

confidence: 99%

Mental health support across the sight loss pathway: a qualitative exploration of eye care patients, optometrists, and ECLOs

Trott

Driscoll

Bourne

et al. 2023

Eye

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“…This resulted in a bibliometric network of 45 unique terms (see Figure 1). (Iglesias & Iglesias, 2009) Case reports United States of America 1 (11) years (Karagiannis et al, 2017) Case report Greece 1 (8) years (Kathol et al, 1983) Follow-up United States of America 8(<18) years (Kramer et al, 1979) Review United States of America Not reported (Laginaf et al, 2021) Survey United Kingdom Not reported (Laria et al, 2009) Case report Spain 1 (9) years (Leaverton et al, 1977) Case report Unites States of America 1 (11) years (Leavitt, 2006) Review United States of America Not reported (Nasiri et al, 2015) Case report Iran 1 (12) years (Østbye et al, 2020) Case report via narrative approach Norway 1 (high school student) (Pula et al, 2015) Retrospective analysis United States of America 8 (mean 16) years (Rada et al, 1978) Case reports United States of America 4 (9, 12, 24, and 25) years (Schneider & Rice, 1979) Review and case reports United States of America 32 (6-18) years (Shindler et al, 2004) Opinion United States of America Not reported (Somers et al, 2016) Prospective and retrospective analysis Belgium 85 (4-15) years (Thieme et al, 2021) Case report Germany 1 (9) years (Turkel, 2015) a Textbook Unknown Children and adolescents (Wherry et al, 1991) Case reports United States of America 1 (11) years (Wynick et al, 1997) Interviews and questionnaires United Kingdom 15 (12-19) years a Of these articles the full texts were not available. Information in the table is derived from the abstract.…”

Section: Data Extractionmentioning

confidence: 99%

Bibliometric mapping of current therapies for children and adolescents with a functional visual disorder (FVD)

Schraauwers,

Ketelaar,

Sterkenburg

2023

British Journal of Visual Impairment

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Children and adolescents with a functional neurological disorder (such as functional visual disorder [FVD]) experience a lower psychological quality of life with more mental health problems than healthy controls. While there is ample research about functional neurological disorder in general, there is also a general lack of research concerning FVD and the effectiveness of treatments given to children and adolescents suffering from it. Our aim was to provide a visual overview of common topics concerning treatments of children and adolescents with an FVD. VOSviewer is a programme that extracts information (terms) from the titles and abstracts of articles to generate bibliometric networks. The results show that common subject terms are paediatrics and children. The common diagnostic terms include conversion disorder, hysterical vision disturbance, somatoform disorders, hysterical disorders, and functional (psychogenic) visual loss. Common therapeutic terms are suggestion therapy, brief psychotherapy, hypnosis, psychiatry, therapeutic processes, and suggestibility. The results give insight into the treatments that children and adolescents with FVD currently receive. We also provide directions for future studies into the treatment of FVD in children and adolescents.

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“…A recent survey of 119 UK ophthalmologists found that 26% did not feel comfortable diagnosing functional visual loss, 59% felt they would not be confident in discussing functional visual loss and 58% felt they would struggle to discuss associated psychological factors if present [2]. It highlighted ambivalent attitudes to management with 37% stating that patients should not be able to claim disability benefits because it may prevent recovery.…”

Section: Introductionmentioning

confidence: 99%

How do I manage functional visual loss

Ramsay,

McKee,

Al-Ani

et al. 2024

Eye

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Functional visual loss is a subtype of functional neurological disorder (FND) and is a common cause of visual impairment seen in both general and neuro-ophthalmological practice. Ophthalmologists can generally diagnose functional visual loss reasonably confidently but often find it harder to know what to say to the patient, how to approach, or even whether to attempt, treatment. There is little evidence-based treatment despite studies showing up to 60% of adults having impactful symptoms on long-term follow-up. The last 20 years has seen large changes in how we understand, approach, and manage FND more widely. In this article, we set out our practical approach to managing functional visual loss which includes : 1) Make a positive diagnosis based on investigations that demonstrate normal vision in the presence of subjectively impaired vision, not just because tests or ocular exam is normal; 2) Explain and label the condition with an emphasis on these positive diagnostic features, not reassurance; 3) Consider eye or brain comorbidities such as migraine, idiopathic intracranial hypertension or amblyopia; 4) Consider working with an orthoptist using diagnostic tests in a positive way to highlight the possibility of better vision; 5) Develop simple treatment strategies for photophobia; 6) Consider psychological factors and comorbidity as part of assessment and therapy, but keep a broader view of aetiology and don’t use this to make a diagnosis; 7) Other treatment modalities including hypnotherapy, transcranial magnetic stimulation and more advanced forms of visual feedback are promising candidates for functional visual loss treatment in the future.

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How do ophthalmologists manage functional visual symptoms? A UK survey of ophthalmologists’ experience

Cited by 7 publications

References 17 publications

Mental health support across the sight loss pathway: a qualitative exploration of eye care patients, optometrists, and ECLOs

Mental health support across the sight loss pathway: a qualitative exploration of eye care patients, optometrists, and ECLOs

Bibliometric mapping of current therapies for children and adolescents with a functional visual disorder (FVD)

How do I manage functional visual loss

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