Non-organic visual loss in children

Citation
Ke. Bain et al., Non-organic visual loss in children, EYE, 14, 2000, pp. 770-772
Citations number
10
Categorie Soggetti
Optalmology
Journal title
EYE
ISSN journal
0950222X → ACNP
Volume
14
Year of publication
2000
Part
5
Pages
770 - 772
Database
ISI
SICI code
0950-222X(200010)14:<770:NVLIC>2.0.ZU;2-N
Abstract
Background Patients with non-organic visual loss (NOVL) can take up a dispr oportionate amount of clinic time and clinicians often resort to expensive and prolonged investigations to ensure the correct diagnosis. This is espec ially the case in children. Methods The case notes of 30 children (18 girls, 12 boys) were retrospectiv ely reviewed following presentation with a primary complaint of visual impa irment and a diagnosis of non-organic visual loss. This figure represents 1 % of new paediatric referrals to our unit. Associated symptoms included hea dache, periorbital pain, diplopia, photopsia and photophobia. Visual field defects were present in 5 patients and spasm of the near reflex in 1 child. Results Treatment consisted of reassurance and was associated with recovery of normal visual function in all cases. Three children were referred to ot her health care professionals. All psychophysical, electrophysiological and neuroradiological investigations were negative. Conclusion Our study shows that non-organic visual loss is relatively commo n in prepubertal children and that this condition can be safely diagnosed u sing standard clinical tests in the majority of cases. Prompt diagnosis pre vents unnecessary investigations and prolonged 'disease' course. Coexisting social conflict was common and may be a contributory factor. Careful expla nation and reassurance to both the child and parents remains the mainstay o f management.