Abstract
The most common complaint in a patient with unconsciously produced ocular hysteria is poor vision. The condition is most often bilateral. Rarely is the complaint that of total blindness. The alleged vision is poor, but the objective refractive error is inconsistent with the subjective visual acuity. The actual visual acuity measurement is frequently normal or near normal, and it may be variable and subject to suggestion. The most common visual field defect seen is tubular. On careful history, many of the patients have a source of stress or conflict in their life that may be so untenable that the unconscious mind has produced the symptoms in attempt to remove itself from the situation. Functional disorders can coexist with organic disease, ranging from 18 to 53 % in studies. With careful reassurance that no serious disease is present and that recovery is expected, the functional condition resolves at least half of the time in adults and in three-quarters of children. A portion (0–11 %) of functional patients may develop an organic disorder on follow-up examination, so a return visit is recommended if the patient does not improve. Serious associated or underlying psychiatric disease is more common in adults than children.
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Enzenauer, R., Morris, W., O’Donnell, T., Montrey, J. (2014). Hysterical Ocular Functional Disorders. In: Functional Ophthalmic Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-08750-4_3
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