Functional visual loss. Issue 2 (April 2017)

• Record Type: Journal Article
• Authors: Dhanji, Shanil; Lawlor, Mitchell
• Is Part Of: Current opinion in neurology. Volume 30:Issue 2(2017:Apr.)
• Publication Date: 2017-04
• Subjects: conversion disorder -- functional visual loss -- medically unexplained; Neurology -- Periodicals; Nervous system -- Diseases -- Periodicals; 616.805
• DOI: 10.1097/WCO.0000000000000423
• Languages: English
• ISSNs: 1473-6551

Abstract

Abstract : Purpose of review: Functional visual loss (FVL) is a syndrome in which subjective visual parameters are inconsistent with objective measures. Recent advances in understanding the pathophysiology and management of functional disorders and FVL will be explored. Recent findings: FVL requires a positive diagnosis of normal function through clinical examination or visual electrophysiology. A substantial proportion of patients have an underlying organic illness that needs to be identified and treated. Recent updates in Diagnostic and Statistical Manual of Mental Disorders-5 reflect the observation that many patients with FVL do not have a recognizable psychological association. A small number of functional neuroimaging studies suggest that there may be a stress-mediated prefrontal suppression of visual awareness. There is limited evidence to guide the treatment of FVL; education and reassurance remain first line, followed by cognitive behavioral therapy and pharmacotherapy for psychiatric comorbidities. Summary: FVL remains a poorly studied and understood condition. Recent advances in the understanding and management of functional symptoms more generally may aid in advancing the understanding of this condition.