Colour Vision Disorder due to Conversion Disorders in Childhood

2021 ◽  
Vol 238 (10) ◽  
pp. 1077-1083
Author(s):  
Deborah-Teresa Thieme ◽  
Romuald Brunner ◽  
Stephanie Kandsperger ◽  
Herbert Jägle
Keyword(s):  
Colour Vision ◽  
Vision Loss ◽  
Multidisciplinary Treatment ◽  
Conversion Disorder ◽  
Successful Outcome ◽  
Visual Field Defects ◽  
Vision Disorder ◽  
Conversion Disorders ◽  
Somatic Comorbidity ◽  
Rule Out

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.

scholarly journals Acute Zonal Occult Outer Retinopathy: Vision Loss in an Active Duty Soldier

2013 ◽  
Vol 2013 ◽  
pp. 1-5
Author(s):  
Courtney M. Crawford ◽  
Bruce A. Rivers ◽  
Mark Nelson
Keyword(s):  
Visual Field ◽  
Visual Field Defect ◽  
Vision Loss ◽  
Fundus Autofluorescence ◽  
Final Diagnosis ◽  
Active Duty ◽  
Visual Field Defects ◽  
Fundus Photographs ◽  
Optical Coherence Tomograph ◽  
Field Defect

Objective. To describe a case of acute zonal occult outer retinopathy (AZOOR) in an active duty patient.Methods. In this paper we studied fundus photographs, optical coherence tomograph, Humphrey visual field 30-2, fundus autofluorescence images, fluorescein angiograms, and electroretinography.Results. Exam findings on presentation: a 34-year-old American Indian female presented with bilateral photopsias, early RPE irregularity, and an early temporal visual field defect. Progression RPE damage and visual field defect along with ERG findings support final diagnosis of AZOOR.Conclusion. AZOOR may initially be identified as a broader category of disease called the “AZOOR complex of disorders”. Specific visual field defects, ERG results, and clinical exam findings will help distinguish AZOOR from other similar disorders.

scholarly journals Characteristics and outcomes of children with dissociative (conversion) disorders in western China: a retrospective study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhixu Fang ◽  
Yuhang Li ◽  
Lingling Xie ◽  
Min Cheng ◽  
Jiannan Ma ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Environmental Variables ◽  
Binary Logistic Regression ◽  
Junior College ◽  
Conversion Disorder ◽  
Psychological Characteristics ◽  
Western China ◽  
Left Behind ◽  
Conversion Disorders ◽  
Close Relationship

Abstract Background Dissociative (conversion) disorder in children is a complex biopsychosocial disorder with high rates of medical and psychiatric comorbidities. We sought to identify the characteristics and outcomes of children with dissociative (conversion) disorders in western China. Methods We conducted a retrospective cohort study of 66 children admitted with dissociative (conversion) disorders from January 2017 to July 2019, and analyzed their clinical characteristics, socio-cultural environmental variables, and personality and psychiatric/psychological characteristics. Binary logistic regression was used to analyze the variables associated with clinical efficacy. Results Of these 66 patients, 38 (57.6%) were male and 28 (42.4%) were female, 46 (69.7%) had an antecedent stressor, 30 (45.5%) were left-behind adolescents, and 16 (24.2%) were from single-parent families. In addition, 30 patients (45.5%) were not close to their parents, 38 patients (59.4%) had an introverted personality, and 34 (53.1%) had unstable emotions. Thirteen families (19.7%) were uncooperative with the treatment. Patients who had cormorbid anxiety or depression exhibited significantly lower cognitive ability (P < 0.01). Logistic regression found that better treatment outcomes were positively associated with having a close relationship with parents, parental cooperation with treatment, and having a father with a lower level of education (i.e., less than junior college or higher). Conclusions The characteristics and outcomes of children with dissociative (conversion) disorders are related to socio-cultural environmental variables and psychiatric/psychological factors. Timely recognition and effective treatment of dissociative (conversion) disorders are important.

scholarly journals Early Recognition of Stroke by Confrontation Visual Field Test – Is It Possible?

2020 ◽  
Keyword(s):  
Case Report ◽  
Visual Field ◽  
Cerebral Artery ◽  
Vision Loss ◽  
Posterior Cerebral Artery ◽  
Early Recognition ◽  
Past History ◽  
Neurological Deficits ◽  
Visual Field Defects ◽  
Axial Tomography

Introduction: Visual field loss is often the first sign of lesion of the anterior or posterior visual pathways. Screening for visual field defects should be a part of all routine eye examinations, mainly when neurological lesions are suspected. A confrontation visual field (CVF) test provide a rapid and practical method of visual field assessment, allowing the recognition of major neurological deficits. Materials and Research Methods: To report a case of posterior cerebral artery (PCA) stroke early suspected by CVF test. Case-Report: A 77 year-old male presented to our emergency department with vision blurring complaints and a strange sensation of a vision loss on one side on the left eye (OS), for the previous 15 days. He explained that symptoms initiated after an episode of dizziness followed by lipothymia. He denied diplopia or headaches. Past history revealed hypertension and diabetes as cardiovascular risk factors. The best corrected visual acuity was 20/25 on right eye (OD) and 20/60 on OS and pupillary reflexes were normal. CVF test was performed and showed a decrease on left hemicampus of OS. The biomicroscopy was normal and the fundus examination showed optic nerve edema bilaterally, also documented by Optical Coherence Tomography. Considering the findings and the history, neuroimaging and a neurological observation were requested. Computerized axial tomography revealed a hypodense lesion in right occipital posterior region, with hematic density. He was hospitalized for proper treatment with the diagnosis of posterior cerebral artery ischemic stroke, with further hemorrhagic transformation. Discussion: In acute stroke, visual disorders may form all or part of the initial presentation. Homonymous visual field deficits are well-known almost universal characteristics of PCA ischemia, however, due to the absent of cognitive impairment or speech problems associated to many cases, the diagnosis can be challenging at early stages. Our case-report highlights the importance of using CVF test to an immediate inspection of the peripheral visual field, in order to detect acute major defects, including homonymous deficits, to understand if a further prompt neurological examination is mandatory.

HYSTERICAL BELCHING AND HYPERVENTILATION: A RARE CASE REPORT

2021 ◽  
pp. 56-57
Author(s):  
Vijay Raj Pratheek P ◽  
Ganta Akhila
Keyword(s):  
Case Report ◽  
Rare Case ◽  
Conversion Disorder ◽  
Conversion Disorders ◽  
Rare Case Report ◽  
Bodily Sensations ◽  
The Individual ◽  
Organic Disorder

Hysteria can present as similar to medical and organic disorder . Conversion symptoms may usually appear due to various stressors and emotional conicts in the individual. The bodily sensations or functions can be inuenced by a disorder of mind. Psychogenic origin of Belching is not unheard of and can be a part of conversion disorder, even though rare. Hyperventilation can occur due to psychogenic aetiology as a manifestation of somatisation and conversion disorders.

Solvent related colour vision loss: an indicator of neural damage?

1987 ◽  
Vol 59 (4) ◽  
pp. 313-321 ◽  
Author(s):  
Donna Mergler ◽  
Lucie Blain ◽  
Jean-Pierre Lagac�
Keyword(s):  
Colour Vision ◽  
Vision Loss ◽  
Neural Damage

Early hydroxychloroquine retinopathy: optical coherence tomography abnormalities preceding Humphrey visual field defects

2019 ◽  
Vol 103 (11) ◽  
pp. 1600-1604 ◽  
Author(s):  
Sean T Garrity ◽  
Joo Yeon Jung ◽  
Olivia Zambrowski ◽  
Francesco Pichi ◽  
Daniel Su ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Field ◽  
Vision Loss ◽  
Tertiary Care ◽  
Fundus Photography ◽  
Visual Field Defects ◽  
Optical Coherence ◽  
Humphrey Visual Field ◽  
Hydroxychloroquine Retinopathy ◽  
Field Defects

Background/AimsHydroxychloroquine (HCQ) retinopathy may result in severe and irreversible vision loss, emphasising the importance of screening and early detection. The purpose of this study is to report the novel finding of early optical coherence tomography (OCT) abnormalities due to HCQ toxicity that may develop in the setting of normal Humphrey visual field (HVF) testing.MethodsData from patients with chronic HCQ exposure was obtained from seven tertiary care retina centres. Ten patients with HCQ-associated OCT abnormalities and normal HVF testing were identified. Detailed analysis of the OCT findings and ancillary tests including colour fundus photography, fundus autofluorescence, multifocal electroretinography and microperimetry was performed in these patients.ResultsSeventeen eyes from 10 patients illustrated abnormalities with OCT and normal HVF testing. These OCT alterations included (1) attenuation of the parafoveal ellipsoid zone and (2) loss of a clear continuous interdigitation zone. Several eyes progressed to advanced parafoveal outer retinal disruption and/or paracentral visual field defects.ConclusionPatients with high risk HCQ exposure and normal HVF testing may develop subtle but characteristic OCT abnormalities. This novel finding indicates that, in some cases of early HCQ toxicity, structural alterations may precede functional impairment. It is therefore important to employ a screening approach that includes OCT to assess for these early findings. Ancillary testing should be considered in cases with suspicious OCT changes and normal HVFs.

scholarly journals Bacteriophage Application for Difficult-to-treat Musculoskeletal Infections: Development of a Standardized Multidisciplinary Treatment Protocol

Viruses ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 891 ◽  
Author(s):  
Onsea ◽  
Soentjens ◽  
Djebara ◽  
Merabishvili ◽  
Depypere ◽  
...  
Keyword(s):  
Multidisciplinary Team ◽  
Phage Therapy ◽  
Clinical Status ◽  
Multidisciplinary Treatment ◽  
Successful Outcome ◽  
Team Approach ◽  
Bacteriophage Therapy ◽  
Musculoskeletal Infection ◽  
Treatment Pathway ◽  
Standardized Treatment

Bacteriophage therapy has recently attracted increased interest, particularly in difficult-to-treat infections. Although it is not a novel concept, standardized treatment guidelines are currently lacking. We present the first steps towards the establishment of a “multidisciplinary phage task force” (MPTF) and a standardized treatment pathway, based on our experience of four patients with severe musculoskeletal infections. After review of their medical history and current clinical status, a multidisciplinary team found four patients with musculoskeletal infections eligible for bacteriophage therapy within the scope of Article 37 of the Declaration of Helsinki. Treatment protocols were set up in collaboration with phage scientists and specialists. Based on the isolated pathogens, phage cocktails were selected and applied intraoperatively. A draining system allowed postoperative administration for a maximum of 10 days, 3 times per day. All patients received concomitant antibiotics and their clinical status was followed daily during phage therapy. No severe side-effects related to the phage application protocol were noted. After a single course of phage therapy with concomitant antibiotics, no recurrence of infection with the causative strains occurred, with follow-up periods ranging from 8 to 16 months. This study presents the successful outcome of bacteriophage therapy using a standardized treatment pathway for patients with severe musculoskeletal infection. A multidisciplinary team approach in the form of an MPTF is paramount in this process.

scholarly journals Conversion disorder: the modern hysteria

2006 ◽  
Vol 12 (2) ◽  
pp. 152-157 ◽  
Author(s):  
Colm Owens ◽  
Simon Dein
Keyword(s):  
Psychiatric Disorders ◽  
Management Strategies ◽  
Historical Context ◽  
Conversion Disorder ◽  
Physical Symptoms ◽  
Organic Disease ◽  
Conversion Disorders ◽  
Case Vignettes

Conversion disorders tend to be poorly understood and diagnosis can be difficult. In this article, we aim to clarify what conversion disorders are and how they can be distinguished from other psychiatric disorders that involve physical symptoms. Prevalence, prognosis and relationship to organic disease are controversial areas; we outline what is known about them and provide some historical context. Aetiological theories and management strategies are discussed, the latter with the aid of case vignettes.

scholarly journals Glaucoma Management in Carotid Cavernous Fistula

2016 ◽  
Vol 7 (2) ◽  
pp. 296-302 ◽  
Author(s):  
Silvia Calafiore ◽  
Andrea Perdicchi ◽  
Gianluca Scuderi ◽  
Maria Teresa Contestabile ◽  
Solmaz Abdolrahimzadeh ◽  
...  
Keyword(s):  
Vision Loss ◽  
Transarterial Embolization ◽  
Multidisciplinary Treatment ◽  
Clinical Signs ◽  
Field Testing ◽  
Laser Iridotomy ◽  
Mri Angiography ◽  
The Right ◽  
Carotid Cavernous Fistulas

Carotid cavernous fistulas (CCF) are vascular communications between the carotid artery and the cavernous sinus. Ophthalmologists are called to diagnose and manage the condition in cases that present with ocular features. A 73-year-old female was referred to our glaucoma center clinic. Eight years before, she had started receiving medication for glaucoma and had undergone laser iridotomy, but a satisfactory management of intraocular pressure (IOP) had not been achieved. The patient was complaining of intermittent diplopia, bilateral proptosis, and conjunctival chemosis over the past 6 months. Best-corrected visual acuity in the right (OD) and left eye (OS) was 9/10 and 10/10, respectively. Visual field testing showed slight paracentral field defects mostly in OS. IOP was 20 mm Hg in OD and 34 mm Hg in OS. We referred the patient to neuroradiology, and MRI angiography revealed a CCF with angiographic classification of Cognard grade 2. Closure of the CCF by transarterial embolization was performed in the neuroradiology department. One week following the procedure, the clinical signs of diplopia, proptosis, and conjunctival chemosis had greatly improved, and IOP was reduced to 12 mm Hg OD and 19 mm Hg in OS. Glaucoma treatment was maintained with topical brimatoprost, brinzolamide, and timolol. Owing to the risk of vision loss associated with vascular stasis, retinal ischemia, and high IOP, ophthalmologists must be aware of the clinical features of CCF and should request appropriate imaging studies such as MRI angiography in order to confirm the diagnosis and plan multidisciplinary treatment.

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