儿童功能性失明

目的 分析4例儿童功能性失明病例,探讨其诊断与治疗.方法 回顾分析门诊诊断为功能性失明的患者4例,其中男性1例,女性3例,年龄7～13岁,均为双眼患病.病史1周至1年.所有患儿均诉说视力下降,视力从数指至0.1,2例伴视野缺损.眼部、神经影像学及眼电生理检查均阴性,诊断为功能性失明.结果 与家长及患儿解释不存在器质病变,视功能可以完全恢复,并辅以非特殊安慰剂治疗后,3例在2 d内视力恢复到1.0,1例1周后视力恢复到1.0,视野扩大至正常.结论 诊断功能性失明需排除眼及神经系统的器质性疾病.儿童功能性失明预后好.

Functional visual loss in children

Objective To analyze 4 cases with functional visual loss and to discuss the diagnosis and management of the disease. Methods The medical charts of four patients diagnosed as functional visual loss were retrospectively reviewed. There were 3 girls and 1 boy, with the age ranged from 7 to 13 years. All were bilaterally involved. Course of disease ranged from one week to one year. Chief complaint was decreased visual acuity with two accompanied by visual field defect. The visual acuity ranged from count finger to 0. 1. Ocular, neuroimaging as well as electrophysiologic exami- nations were all normal. Results With reassurance and assisted with nonspecific placebo treatment, the visual acuity recovered to 1.0 within 2 days in 3 cases and one week in the remaining one, visual field expanded to normal as well. Conclusions Diagnosis of functional visual loss need to rule out all organic ocular and neurological diseases. Functional visual loss in children has good prognosis. （Chin J Ophthalmol and Otorhinolaryngo1,2008,8：21-23 ）