Abstract
[Purpose] In ophthalmology, it is not common that patients with functional visual loss claim color vision defects as their chief complaint. Here we reported a case of functional visual loss demonstrating color vision defects after temporary hearing loss.
[Case] A 15-year-old female patient reported temporary hearing loss in the left ear in January 2013. The patient exhibited color vision defects in the right eye and visited a local eye clinic in February 2013. In March 2013, the patient was referred to the Department of Ophthalmology at the Jikei University School of Medicine. Her decimal best corrected visual acuity was 1.5 in the right eye and 1.2 in the left eye. No abnormality was found in the anterior segments, media, and fundus in both eyes. Goldmann visual field finding was normal, and electroretinography also showed normal implicit times and amplitudes for both eyes. We then performed color vision tests monocularly. The Ishihara test demonstrated 8 errors for the right eye and 4 errors for the left eye. The Panel D-15 test showed a fail pattern for the right eye but no error for the left eye. The total error scores were 148 (outside the normal range) for the right eye and 84 (within the normal range) for the left eye by the Farnsworth-Munsell 100-Hue (F-M 100 Hue) test. The patient underwent a brain MRI and acoustic neuroma on the left side of the brain was detected. In June 2013, the patient reported improvement in subjective color vision. The same color vision tests were performed again in July 2013. The Ishihara test demonstrated 2 errors for the right eye and 1 error for the left eye. In the Panel D-15 test, no error was found for either eye showing signs of improvement. However, the total error scores of the F-M 100 Hue test were 108 for the right eye and 124 for the left eye, which were both outside the normal range.
[Conclusion] At the time of the onset of the color vision defects, the patient was under the pressure of taking the high school entrance examination and had experienced temporary hearing loss. Considering all the normal findings by various ophthalmic examinations, we concluded that the color vision defects were likely to be associated with psychogenic functional visual loss due to stress for various causes.
