Hysteria (malingering; ophthalmic flake syndrome)

General: Willful or unwillful exaggeration or simulation of symptoms of an ill 818i81i ness without physiologic cause; frequently secondary to a state of anxiety; may be seen more in children; physical or sexual abuse may be a predisposing factor.

Ocular: Anxiety-induced angiospastic or central serous retinopathy; self-induced conjunctivitis; traumatic epithelial erosions; herpetic keratitis; angioneurotic edema; contact dermatitis; ptosis; recurrent herpetic vesicles; anisocoria; peculiar pupillary reflexes; accommodative spasm; amaurosis fugax; anxiety-induced optic neuritis; disturbance of conjugate movement; dyschromatopsia; facial tic; hypersecretion glaucoma; increased or decreased tear secretion; night blindness; nystagmus; photophobia; strabismus; visual loss; psychogenic amaurosis with headaches.

Clinical: Aphonia; deafness; paralysis of limb; hemiplegia; dissociative state; anxiety; insomnia; tachycardia; shortness of breath; fatigue; vertigo, chest pains.

Barris MC, et al. Visual impairment in hysteria. Doc Ophthalmol

Catalano RA, et al. Functional visual loss in children. Ophthalmology 1986; 93:385-390.

Fraunfelder FT, Roy FH. Current Ocular Therapy, 5th ed. Philadelphia: WB Saunders, 2000.

Kramer KK, et al. Ocular malingering and hysteria: diagnosis and management. Surv Ophthalmol 1979; 24:89-96.

Miller BW A review of practical tests for ocular malingering and hysteria. Surv Ophthalmol 1973; 17:241-246.

Ziegler DK, Schlemmer RB. Familial psychogenic blindness and headache: a case study. J Clin Psychiatry 1994; 55: 114-l17.