The causes, diagnostics, and treatment of psychogenic blindness – a systematic review

Piotr  Sikorski; Agata  Gurdak; Kinga  Gurdak; Dorota  Szewczyk; Jakub  Fiega; Urszula  Żurek; Zuzanna  Lubaszka; Marcin  Łapiński; Milena  Michalska; Marcin  Fudalej; Ewa  Sikorska; Sylwia  Fudalej

doi:10.12923/2353-8627/2023-0023

Authors

Piotr Sikorski Department of Psychiatry, Medical University of Warsaw, Poland Author https://orcid.org/0000-0003-1629-2784
Agata Gurdak Medical University of Warsaw, Poland Author https://orcid.org/0009-0008-2137-7612
Kinga Gurdak Medical University of Warsaw, Poland Author https://orcid.org/0009-0009-1474-9630
Dorota Szewczyk Międzyleski Specialist Hospital, Poland Author https://orcid.org/0009-0008-9269-2687
Jakub Fiega Provincial Integrated Hospital in Kielce, Poland Author https://orcid.org/0009-0007-9188-1382
Urszula Żurek Warsaw Southern Hospital, Poland Author https://orcid.org/0009-0008-3482-5381
Zuzanna Lubaszka Provincial Integrated Hospital in Kielce, Poland Author https://orcid.org/0009-0008-3034-1697
Marcin Łapiński Medical University of Warsaw, Poland Author https://orcid.org/0000-0003-2596-1492
Milena Michalska State Medical Institute of MSWiA, Poland Author https://orcid.org/0000-0002-8052-5661
Marcin Fudalej Department of Forensic Medicine, Medical University of Warsaw, Poland Author https://orcid.org/0000-0001-9652-2687
Ewa Sikorska Chair and Department of Experimental and Clinical Physiology, Medical University of Warsaw, Poland Author https://orcid.org/0000-0003-2352-650X
Sylwia Fudalej Department of Psychiatry, Medical University of Warsaw, Poland Author https://orcid.org/0000-0003-3610-7312

DOI:

https://doi.org/10.12923/2353-8627/2023-0023

Keywords:

psychogenic blindness, conversion disorders, causes

Abstract

Introduction: Conversion disorders are characterized by the presence of motor or sensory dysfunction, resulting in significant discomfort or disability, the occurrence of which is not justified by any somatic disease. Psychogenic blindness, a specific manifestation of conversion disorders, refers to the loss or impairment of vision that cannot be attributed to any organic abnormalities in the eyes or visual system. The exact mechanisms underlying psychogenic blindness are not fully understood, but it is believed to involve complex interactions between the brain, visual pathways, and psychological processes. This systematic review aims to summarize reported cases of blindness in conversion disorders.

Material and methods: A comprehensive search of the MEDLINE and Embase databases identified 13 relevant articles reporting a total of 17 patients with psychogenic blindness.

Results: The risk and triggering factors for psychogenic blindness included acute stress (for example acute physical injury), chronic stressful situations (such as chronic health problems, disruptions in family relationships), and multiple factors including coexisting psychiatric conditions (like anxiety or other conversion disorders). The course of blindness varied among patients, with duration ranging from hours to years. Diagnostic methods involved thorough ophthalmic and neurological examinations, brain imaging, and psychiatric evaluations.

Conclusions: This review provides valuable insights into managing patients with psychogenic blindness. The findings highlight the need for a multidisciplinary approach involving ophthalmologists, neurologists, and mental health specialists. Further research is required to elucidate the underlying mechanisms and develop effective treatment strategies for individuals with psychogenic blindness.

References

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The causes, diagnostics, and treatment of psychogenic blindness – a systematic review

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