Visual Conversion Reaction in Children and Adults

Tip of iceberg: when unusual vision complaints with a normal examination prompt a closer look

“…Regardless of the severity of the patient's clinical presentation, several studies have shown that the most effective management of NOVL is reassurance and follow-up [6,13,16–18]. Psychotherapy is rarely indicated and has not been shown to improve outcome [2,14,15].…”

Visual conversion reaction in children

“…Decreased visual acuity may be monocular or binocular and the amblyopia may vary in depth from 'light perception' to 6/9 (Yasuna, 1963). The visual acuity may vary from one examination to the next or with suggestion (Rada, Meyer and Kellner, 1978).…”

“…Visual field defects may take the form of monocular hemianopia (Kathol et ul., 1983b), bitemporal defects, binasal hemianopias (Smith, Beck and Mills, 1983), central and ring scotomas (Lincoff and Ennis, 1956). 'Tubular' fields, in which the visual fields are reduced in size and which remain constant in size irrespective of the testing distance (Rada, Meyer and Kellner, 1978), 'spiral' fields (Smith, Beck and Mills, 1983), oscillatory and 'star-shaped' fields (Krill and Newell, 1968) also occur.…”

“…Visual dysfunction without organic cause has been described as 'psychogenic visual disturbance' (Freud,191 O), 'hysterical blindness' (Wolff and Lachman, 1938), 'hysterical amblyopia' (Yasuna, 1963), 'ocular conversion reaction' (Krill and Newell, 1968), 'visual conversion reaction' (Rada, Meyer and Kellner, 1978), 'psychogenic amblyopia' (van Balen and Slijper, 1978) and 'amblyopic schoolgirl syndrome' (Mantyjarvi,198 1 ).…”

Detection of Nonorganic Visual Loss with a New Optotype Chart in Simulated Malingerers

“…It occurs most often in children and young adults [5] and may be conversional or caused by malingering. While hysterical patients are unaware of their dissembling, malingerers consciously dissemble the disease.…”