成人の心因性視覚障害―小児と比較した特異性

Characteristics of psychogenic visual disturbance in adults. As different from children

8年9か月間に71例131眼を心因性視覚障害と診断した。内訳は20歳以上の成人33例59眼と15歳未満の小児38例72眼であり，病態の特徴，診断した根拠，推定された心因を比較検討した。小児では心因が単純で回復しやすい傾向があり，成人では心因が複雑で治癒が困難な傾向があった。心因性視覚障害は，眼または全身疾患が基礎にあり，多くのストレスが加重して治癒しにくい「高齢型」，ストレスが原因不明で治癒しにくい「不明型」，眼または全身疾患がなくストレスの原因が明確で治癒しやすい「単純型」の3群に分類できた。小児では単純型の頻度が58％であり，成人では高齢型と不明型が合わせて48％あり，単純型は30％であった。

We diagnosed 71 cases as psychogenic visual disturbance during the past 105months. The series comprised 59 eyes of 33 adults aged 20 years or over and 72 eyes of 38 children aged less than 15 years. These cases were reviewed regarding clinical features,reasons for diagnosis,and presumed psychogenic causes. The underlying causes were generally simple with a tendency to spontaneously recover in children. Multiple causes were involved in adults with a tendency to run protracted courses. We could classify psychogenic visual disturbance into 3 types. Simple type was characterized by easily identifiable causes with a tendency to spontaneous cure. Aged type had multiple causes and tended to run a protracted course. Unknown type had ambiguous underlying causes and was difficult to cure. The incidence of simple type was 58％ in children and 30％ in adults. That of aged and unknown type was 48％ in adults.