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Blurred vision due to psychosocial difficulties: a case series.

Middleton EM, Sinason MD, Davids Z

1University College London Hospitals (UCLH NHS Trust), London, UK.

PurposeThe association between psychological difficulties and accommodative insufficiency in children and young adults has been previously reported. The authors give their experiences with such cases and address the research and service developments required to deal with these problems.MethodsWhen no other organic pathology was found in full ophthalmological assessment, and where insufficient improvement in accommodation was found in orthoptic treatment, the patients were referred to liaison psychiatry or to adult or child psychotherapy services for assessment.Results and conclusionsSome cases of accommodative insufficiency referred for ophthalmological assessment were found to have psychosocial difficulties, which played a role in the development of the complaint. For patients and clinicians, it is hard to understand how there can be a psychosomatic translation between personal difficulties and ocular symptoms. The authors use the concept of alexithymia to recognise that some people cannot describe their emotions in words and can only express them physically. The joint management of these cases by both psychiatry and ophthalmology has been valued by the patients.Eye (2008) 22, 316-317; doi:10.1038/sj.eye.6703009; published online 19 October 2007.

Published 14 February 2008 in Eye, 22(2): 316-7.
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