Treatments for psychogenic visual disturbance include autogenic training, sand play therapy, suggestion therapy, behavior therapy and drug therapy, etc. We report our experience with a case of psychogenic visual disturbance who showed marked improvement by sand play therapy. The case is a twelve-year-old boy. Growth, past history and family history are unremarkable. The family consists of the parents, the patient and a younger brother. In the sixth grade, the patient was seriously troubled over low height and he disliked going to school to avoid an athletic meet and swimming. Upon medical exwamination at school. visual disturbance was noted. The child was referred to an ophthalmologist and was diagnosed as psychogenic visual disturbance. Right visual acuity was 0.15. left visual acuity was 0.2. Psychological testing indicated the child had tendencies toward introversion, high psychological tension along with a loss of self-confidence. In the family he is dependent on mother and has sibling rivalry. We suggested that the psychogenic visual disturbance was due to these problems. In an early interview, he was tense, silent and had difficulty in verbal expression. Therefore in every interview we encouraged him to. talk about school and family, and tried to praise him to increase his self-confidence. We used sand play therapy adjunctively as a non-verbal approach. In early sand play he used a few toys and we felt vacant. But gradually a number of toys were used and contents became richer. In later interviews he talked much about his family and friends. He also played with his friends after school and on holidays, played with his brother, and became less dependent on his mother. Furthermore, after eight months from the day of his first medical examination, the child's both visual acuities improved to 1.0.
