1985 Volume 25 Issue 6 Pages 491-497
The twelve children with psychogenic visual disorder from eight years to fourteen years of age, average 10.4 years were psychosomatically investigated. All of the subjects showed positive response to the trick test of visual acuity while their visual acuities examined by the routine method were below 1.0 ranging from 0.02 to 0.6 (mean 0.32). In nine of them spiral form of visual field was presented.Eight children were the youngest children of the family and others were the eldest including one only child. They attended "Juku" school 3.3 times a week on the average (the mean value in Osaka was 2.4). The rearing attitudes of their mother showed the tendency of meddiesomeness, anxiety and compulsiveness as a whole. The children with the disorder showed the characteristic personality trait including perfectionistic, compulsive, industrious and aggressive tendencies. The visual disorder accompanied with spiral visual field had been identified as hysterical nature since Charcot. However the children examined in this study did not complaind of anything like visual problems at all and did not exhibit the characteristic hysterical personality. So neither flight into diseases nor gains from illness were expected for these children as a defense mechanism of psychogenic disorders. After pointing out the symptom and the following psychiatric treatment a half of the children were got rid of the disorder within six months. Furthermore most of the children had several psychosomatic symptoms other than visual disorder, as for example, headache, abdominal pain, dizziness, enuresis nocturna, general fatigue and psychogenic deafness.As a result of the present investigation, the author posturated that the pathogenesis of a visual disorder without subjective complaint was more attributed to the process of psychosomatic disease than hysterical one. And it was more likely that the visual symptom in Japanese children was precipitated by so called educational stress which is prevailing among the psychosomatic symptoms in Japanese school children. To prove this notion, further extensive investigations for school children from the ophthalmologic as well as psychiatric view points are to be proposed.
