Acute bilateral loss of vision as organic manifestation of repressed psychological stress : report of an interesting case

Introduction : 
Acute bilateral vision loss in the absence of organic cause may suggest visual conversion disorder. 

Case report : 
Herein, the authors present a rare case of dysthymic disorder complicated with visual conversion disorder, presented as painless acute bilateral loss of vision. A series of ophthalmologic diagnostic tests including the anterior and posterior segment ocular examination, RAPD, fogging test, menace reflex, computed tomography and magnetic resonance imaging of the brain, visual evoked potential (VEP), and electroretinography (ERG) were found to be normal, despite patient having no perception to light. Upon referral to a trained psychiatrist, identification of significant psychological stressors was addressed with supportive pharmacotherapy, psychotherapy, psychoeducation and cognitive behavioural therapy, which gradually restored functional visual acuity. 

Discussion / Conclusion :  
Therefore, multidisciplinary approach in functional vision loss should be reinstituted early in therapy to avoid delay in management and clinical outcome.

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