The causes, diagnostics, and treatment of psychogenic blindness – a systematic review

Abstract

Introduction: Conversion disorders are characterized by the presence of motor or sensory dysfunction, resulting in significant discomfort or disability, the occurrence of which is not justified by any somatic disease. Psychogenic blindness, a specific manifestation of conversion disorders, refers to the loss or impairment of vision that cannot be attributed to any organic abnormalities in the eyes or visual system. The exact mechanisms underlying psychogenic blindness are not fully understood, but it is believed to involve complex interactions between the brain, visual pathways, and psychological processes. This systematic review aims to summarize reported cases of blindness in conversion disorders. Material and methods: A comprehensive search of the MEDLINE and Embase databases identified 13 relevant articles reporting a total of 17 patients with psychogenic blindness. Results: The risk and triggering factors for psychogenic blindness included acute stress (for example acute physical injury), chronic stressful situations (such as chronic health problems, disruptions in family relationships), and multiple factors including coexisting psychiatric conditions (like anxiety or other conversion disorders). The course of blindness varied among patients, with duration ranging from hours to years. Diagnostic methods involved thorough ophthalmic and neurological examinations, brain imaging, and psychiatric evaluations. Conclusions: This review provides valuable insights into managing patients with psychogenic blindness. The findings highlight the need for a multidisciplinary approach involving ophthalmologists, neurologists, and mental health specialists. Further research is required to elucidate the underlying mechanisms and develop effective treatment strategies for individuals with psychogenic blindness. Keywords: psychogenic blindness, conversion disorders, causes