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Ocular Münchausen syndrome resulting in bilateral blindness

Salvo, Marco Michele and Pinna, Antonio <1963- > and Milia, Paolo and Carta, Francesco (2006) Ocular Münchausen syndrome resulting in bilateral blindness. European Journal of Ophthalmology, Vol. 16 (4), p. 654-656. eISSN 1724-6016. Article.

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Abstract

PURPOSE. Münchausen syndrome is a factitious disorder in which patients knowingly harm themselves for subconscious psychological reasons in order to be hospitalized. Recognition of this psychopathology is important, to prevent potentially severe eye damage. Ocular Münchausen syndrome is uncommon. The authors describe an elderly woman with recurrent, probably self-induced, ocular trauma leading to bilateral blindness. The authors are unaware of any previously reported cases of Münchausen syndrome resulting in bilateral blindness and occurring in old age. CASE REPORT. A 73-year-old woman was first seen in 1991 with a closed-globe injury to the right eye, apparently following a household fall. Physical examination showed no sign of extraocular trauma. Right visual acuity was 20/30 after 2 months. She was readmitted in May 2003 with left globe rupture, allegedly following a domestic fall. No extraocular trauma was found. She developed ocular phthisis 6 months postoperatively. The patient was admitted again in February 2004 with right globe rupture, following another alleged domestic fall. Physical examination showed no sign of extraocular trauma. Right visual acuity was 20/400 2 months postoperatively. Psychiatric evaluation revealed Münchausen syndrome. Psychotherapy was prescribed, but refused by her family. CONCLUSIONS. Diagnosis of Münchausen syndrome is difficult to make in the ophthalmic department. Münchausen patients have little or no ability to control their self-destructive behavior. A sympathetic and supportive approach is therefore required and these patients should be urgently referred to a psychiatrist with experience in factitious disorders. Even with psychotherapy, which is often refused, the prognosis remains poor.

Item Type:Article
ID Code:4404
Status:Published
Refereed:Yes
Uncontrolled Keywords:Bilateral blindness, ocular Münchausen syndrome, self-inflicted eye injuries
Subjects:Area 06 - Scienze mediche > MED/30 Malattie apparato visivo
Divisions:001 Università di Sassari > 03 Istituti > Oftalmologia, Otorinolaringoiatria e Urologia
Publisher:Wichtig Editore Srl
eISSN:1724-6016
Deposited On:30 Aug 2010 13:57

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