Prevalence of psychosocial disturbances in children with nonorganic visual loss.

Taich A, Crowe S, Kosmorsky GS, Traboulsi EI.

Case Western Reserve University School of Medicine, Cleveland, OH, USA.

PURPOSE: To report on the prevalence of psychiatric disease and psychosocial stress in children with nonorganic visual loss. MATERIALS AND METHODS: Case series of 71 consecutive pediatric patients with a variety of nonorganic visual signs and symptoms. Chart review of ophthalmologic findings and details of medical and social history with main outcome measures of prevalence of psychiatric disease and psychosocial stress. RESULTS: Psychological/psychiatric disturbances in the form of anxiety, depression, and attention deficit hyperactivity disorder had been previously diagnosed in 19 (26.7%) patients. We had a very high index of suspicion of psychiatric illness in another four patients. Furthermore, we uncovered significant home and school stress in 22 (31%) patients. Sixteen (22.5%) patients wanted glasses and in 10 (14.1%) patients no cause for the behavior could be determined. Of those patients who wanted glasses, girls outnumbered boys 3:1. CONCLUSIONS: An underlying psychiatric or psychosocial disturbance should be ruled out in children who present with nonorganic visual loss.