Visual conversion reaction in children

Abstract

Visual conversion reaction (VCR) is a psychosomatic illness that will occasionally be seen by optometrists and ophthalmologists. This paper discusses some of the possible aetiologies and manifestations of the condition. Investigation and management of children with suspected VCR is discussed. Four case histories are presented in which signs of VCR included amblyopia, reduced accommodation and a deterioration in handwriting. The visual field defects presented include a static quantitative anomaly. Such a defect has not previously been reported.

Tip of iceberg: when unusual vision complaints with a normal examination prompt a closer look

“…Many of these patients initially present to their primary care physician before seeing an ophthalmologist, so there is significant value in promoting more awareness about this disease. NOVL occurs most frequently in girls aged 8-13 [3,4]. The most common clinical presentation is reduction in visual acuity with symmetric, bilateral eye involvement [5].…”

Psychogenic Disorders of Vision in Childhood (“Visual Conversion Reactions”): Perspectives from Adolescence: A Research Note

“…Eames' 1947 study revealed that 9 % of a sample of 193 unselected school children had the tubular field defects characteristic of VCR. Children most commonly present at the age of 9-11 years, with some studies showing a second peak at puberty (Barnard, 1989); girls are more commonly affected than boys. Vision is usually blurred but rarely absent in one or both eyes, and there is sometimes associated diplopia or headaches.…”