J Korean Ophthalmol Soc.  2016 Sep;57(9):1435-1440. 10.3341/jkos.2016.57.9.1435.

The Clinical Features and the Prognosis of Functional Visual Loss in Children

• Lee SH
• Shin KS
• Lee YH

• KMID: 2351875
• DOI: http://doi.org/10.3341/jkos.2016.57.9.1435

Abstract

PURPOSE
To evaluate the clinical characteristics and prognoses of children with functional visual loss.
METHODS
Retrospective medical record review was performed in 53 patients 4 to 16 years of age diagnosed with functional visual loss between April 2006 and February 2014. We investigated the clinical features and results of clinical tests and the final status of the patients.
RESULTS
Twenty male (37.8%) and 33 female (62.2%) patients were included in the study. The mean age was 9.69 ± 2.76 years. The incidence was highest between 8 to 12 years. The mean best corrected visual acuity at baseline was 0.43 ± 0.23, and 88.7% of patients had mild to moderate visual loss. The symptoms were bilateral in 96.2% of patients, and the difference of corrected visual acuity between two eyes was 1 line or less on Snellen chart in 94.1% of bilateral cases. The symptoms were resolved by 1.8 ± 1.0 months in 59.5% of patients and resolved by the final follow-up visit in 51 (96.2%). However, the symptoms persisted through the final follow-up in 2 patients.
CONCLUSIONS
Most children with functional visual loss have bilateral and mild to moderate visual loss. The prognosis of functional visual loss in children was excellent. Most patients recovered from the disease with reassurance supportive care without psychiatric treatment, although a few patients had persistent symptoms.

Keyword

Functional visual loss; Non-organic visual loss; Psychogenic visual loss

MeSH Terms

Child*
Female
Follow-Up Studies
Humans
Incidence
Male
Medical Records
Prognosis*
Retrospective Studies
Visual Acuity

Figure

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  Figure 1. The distribution of age and sex of the subjects. Female was more common and patients between 8 and 12 years old were most common.

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  Figure 2. The distribution of visual loss in the subjects. Most subject showed mild or moderate visual loss. Mild: best-cor-rected visual acuity (BCVA) ≥ 0.5; Moderate: 0.2 ≤ BCVA < 0.5; Severe: BCVA < 0.2.

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  Figure 3. Difference of line on snellen visual acuity chart between both eyes in bilateral cases. Most of bilateral cases showed the difference of visual acuity less than 1 line between both eyes.

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  Figure 4. Flow chart of the diagnosis and course. Number of eligible patients was 53. Normal visual acuities were proved in 47 patients on initial visit. Forty five of them recovered from their symptom and sign spontaneously. But two patients had persistent symptom. Normal visual acuities were not proved in 6 patients on initial visit. All of them recovered from their symptom and sign spontaneously.

Reference

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