A Clinical Study of Children with Functional Visual Disorder

Abstract

Eighteen children (3 males, 15 females) with functional visual disorder were clinically investigated. The subjects were aged from 7 to 14,10.1 being the average. Ophthalmological examination including electro-retinography and visual evoked potential, revealed no particular findings. All of the children showed positive response from the visual acuity trick test, though their visual acuity ranged from 0.1 to 0.8 at the first examination. It was found that 9 children had spiral visual field, that 11 had narrowed visual field and that 8 of them had both spiral and narrowed visual field. Of these, 10 were accompanied with psychosomatic symptoms such as headache, abdominal pain, asthma and nocturnal enuresis. The subjects were divided into 4 groups including 1) psychogenic traumas type (6 cases), 2) conflictual situations type (3 cases), 3) introverted character type (6 cases), and 4) overadaptive type (3 cases). The author analysed the subjects nosologically and the following results were obtained : 1) The visual symptoms appeared after psychological traumas in 6 patients (psychogenic traumas type). It is suggested that psychological traumas caused in them acute psychogenic reactions. 2) Three patients revealed some conflictual situations in their families (conflictual situations type). It is suggested that the conflictual situations caused in them chronic psychosomatic reactions. Their prognoses were poor. Nine patients revealed neither psychogenic traumas nor conflictual situations in their families. Six of them have introverted characters (introverted character type). It is suggested that they suppress psychogenic conflicts in their daily life, which caused in them psychosomatic symptoms. They can be considered hysteria. 3) Three patients were in over adaptive state, which is one of the factors of psychosomatic disease in adult (over adaptive type). As a result of this investigation, the author stressed that functional visual disorder should be approached psychosomatically, considering the children's psychosomatic development and background.