Colour Vision Disorder due to Conversion Disorders in Childhood

Abstract

Background Non-organic vision loss can manifest in various ways, most commonly in the form of reduced vision and visual field defects. Colour vision disorders in the context of a conversion disorder have only rarely been reported.

Materials and Methods This review presents the case of a 9-year-old boy with a colour vision disorder as the isolated symptom of a conversion disorder. The challenging in this case was an additional somatic comorbidity – a congenital red-green deficiency. Consequently it was difficult to make a diagnosis and to convince the parents.

Conclusion It is important to rule out organic causes and establish the diagnosis of a conversion disorder. In these cases, multidisciplinary treatment is crucial for a successful outcome. The diagnosis may be especially challenging when the patients have both somatic and psychogenic complaints.

Key words

colour vision disorder - functional visual disorder - conversion syndrome

Publikationsverlauf

Eingereicht: 17. August 2021

Angenommen: 06. September 2021

Artikel online veröffentlicht:
18. Oktober 2021

• References/Literatur

• 1 Langmann A, Lindner S, Kriechbaum N. Funktionelle Sehstörung als Konversionssymptom im Kindes- und Jugendalter. Klin Monbl Augenheilkd 2001; 218: 677-681 DOI: 10.1055/s-2001-18390.
• 2 Krastel H, Kolling G, Schiefer U. et al. Qualitätsanforderungen an die Untersuchung des Farbsinns. Ophthalmologe 2009; 106: 1083-1102 DOI: 10.1007/s00347-009-1976-3.
• 3 Jaeger W, Krastel H, Seiberth V. et al. Ein Farbtafeltest zur Früherkennung und quantitativen Verlaufskontrolle von Ethambutol-Nebeneffekten am Sehnerv: Der „65-test“. Fortschr Ophthalmol 1985; 82: 571-577
• 4 Sharpe LT, Stockman A, Jägle H, Nathans J. Opsin genes, cone photopigments, color vision, and color blindness. In: Gegenfurtner KR, Sharpe LT. eds. Color Vision: From genes to perception. Cambridge: Cambridge University Press; 1999: 3-51
• 5 Nathans J, Thomas D, Hogness D. Molecular genetics of human color vision: the genes encoding blue, green, and red pigments. Science 1986; 232: 193-202 DOI: 10.1126/science.2937147.
• 6 Cole BL, Henry GH, Nathan J. Phenotypical variations of tritanopia. Vision Res 1966; 6: 301-313 DOI: 10.1016/0042-6989(66)90064-2.
• 7 Pokorny J, Smith VC. Eye disease and color defects. Vision Res 1986; 26: 1573-1584 DOI: 10.1016/0042-6989(86)90176-8.
• 8 Barnard NAS, Birch J, Wildey H. Concurrent visual conversion reaction and simulated colour vision defects in a 12-year-old child. Ophthalmic Physiol Opt 1990; 10: 391-393 DOI: 10.1111/j.1475-1313.1990.tb00888.x.
• 9 Krill AE. Retinal function studies in hysterical amblyopia. A unique abnormality of dark adaptation. Am J Ophthalmol 1967; 63: 230-237 DOI: 10.1016/0002-9394(67)91542-5.
• 10 Pickford RW. A case of hysterical colour blindness reconsidered. Mod Probl Ophthalmol 1972; 11: 165-167
• 11 Fodor N. Hysterical color blindness; caused by infantile sexual guilt. J Clin Exp Psychopathol 1946; 8: 279-289
• 12 Feinstein A. Conversion disorder: advances in our understanding. CMAJ 2011; 183: 915-920 DOI: 10.1503/cmaj.110490.
• 13 Mursch-Edlmayr AS, Mojon D, Bolz M. Prüfung und Vorgehen bei Verdacht auf nichtorganische Sehstörung. Ophthalmologe 2018; 115: 77-87 DOI: 10.1007/s00347-017-0628-2.
• 14 Muñoz-Hernández AM, Santos-Bueso E, Sáenz-Francés F. et al. Nonorganic Visual Loss and Associated Psychopathology in Children. Eur J Ophthalmol 2012; 22: 269-273 DOI: 10.5301/EJO.2011.8378.
• 15 Freud S. Die psychogene Sehstörung in psychoanalytischer Auffassung. Ärztliche Fortbildung, Beiheft zu Ärztliche Standeszeitung 1910; 9 (09) 42-44
• 16 Schönfeldt-Lecuona C, Connemann BJ, Höse A. et al. Konversionsstörungen: Von der Neurobiologie zur Behandlung. Nervenarzt 2004; 75: 619-627 DOI: 10.1007/s00115-003-1650-y.
• 17 Brunner R, Jägle H, Kandsperger S. Dissoziative Sehstörungen bei Kindern und Jugendlichen. Klin Monbl Augenheilkd 2021; 238: 1084-1091
• 18 Maldonado J, Butler L, Spiegel D. Treatments for Dissociative Disorders. In: Nathans PE, Gorman JM. eds. A Guide to Treatments that work. New York: Oxford University Press; 2002: 423-446
• 19 Yamazaki H, Munakata S. Accommodation power determined with visual evoked cortical potentials in psychogenic visual disturbances. Doc Ophthalmol 1995; 90: 271-277 DOI: 10.1007/BF01203862.
• 20 Barnard NA. Visual conversion reaction in children. Ophthalmic Physiol Opt 1989; 9: 372-378
• 21 Kathol RG. Functional Visual Loss: Follow-up of 42 Cases. Arch Ophthalmol 1983; 101: 729 DOI: 10.1001/archopht.1983.01040010729005.
• 22 Mojon DS, Schläpfer TE. Nichtorganische Störungen in der Ophthalmologie: Übersicht der Diagnostik und Therapie 1. Klin Monbl Augenheilkd 2001; 218: 298-304 DOI: 10.1055/s-2001-15885.
• 23 Bruce BB, Newman NJ. Functional Visual Loss. Neurol Clin 2010; 28: 789-802 DOI: 10.1016/j.ncl.2010.03.012.
• 24 Trauzettel-Klosinski S. Untersuchungsstrategien bei Simulation und funktionellen Sehstörungen. Klin Monbl Augenheilkd 1997; 211: 73-83 DOI: 10.1055/s-2008-1035101.
• 25 Villegas RB, Ilsen PF. Functional vision loss: a diagnosis of exclusion. Optometry 2007; 78: 523-533 DOI: 10.1016/j.optm.2007.04.098.