Oftalmologia Pediátrica, Serviço de Oftalmologia, Centro Hospitalar de Lisboa Central
- Apresentado na sessão focus digital session 5 – Low Vision, CVI and Screening no 3.rd World Congress of Paediatric Ophthalmology and Strabismus (WCPOS), Barcelona, Espanha, Setembro de 2015 e em sessão clínica hospitalar.
Introduction: Conversion Disorder presents with signs or symptoms of neurologic disease that occur in the absence of a proven organic substrate. It is rather frequent in young children and teenagers. In Visual Conversion Disorder visual symptoms dominate, the more typical being decreased vision, visual field defects, intermittent diplopia and problems related to reading or writing. Unconscious psychological conflicts, secondary to stressful life events, correlate strongly with the development of Conversion Disorder.
Purpose: to review Visual Conversion Disorder in the pediatric population, through the description of two cases with positive outcome.
Description: the authors report the cases of two young girls, aged 7 and 9 years old, who presented with decreased vision and visual field constriction without an apparent cause. Both were submitted to extensive workup and a Conversion Disorder was presumptively considered after exclusion of underlying organic disease and malingering. Treatment was based on positive feedback, patient motivation and the simple assurance offered by a normal eye exam. Psychological and educational supports were offered throughout the entire treatment process.
Outcome: in both girls, vision and visual field amplitude were completely recovered, over individual follow up durations.
Conclusion: Visual Conversion Disorder is diagnosed by exclusion. Delays in its recognition expose the patient to unnecessary interventions, postponing adequate treatment. The condition has a good prognosis, since visual function can be recovered in the majority of cases.