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Dr. Chan
Dr. Chan, Ophthalmologist
Category: Eye
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Experience:  Board Certified in ophthalmology
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Please Help!!! My daughter has had a sudden loss of vision

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Please Help!!! My daughter has had a sudden loss of vision in both eyes. She is 24 weeks pregnant. This happened last Thursday while we were riding down the street. She was admitted to the hospital for 3 days, but was discharged with only a hope. The doctors could not find anything medically wrong. They have checked her eyes and done an MRI and MRA and found nothing.
She was laid off from her job, lost her insurance and now has medicaid. It seems they are brushing her off and no one cares. All doctors have been somewhat unfriendly to us and our concerns. Being partially blind is adding stress and fustration to her and all worried about her.
Any ideas?



That sounds like a scary thing to happen. Did she lose total vision? Or just part of her vision? Did she have any headaches? Does she have any other medical condition? Is this her first pregnancy?

Customer: replied 7 years ago.
She can see colors clarification of what the color is on. She has headaches almost daily, but was told that was because of the Zofran she takes daily for nausea. She has no other medical problems and yes this is her first child although she has had an D&E before.



This is a very odd situation. The MRI/MRA ruled out strokes, aneurysms. Only systemic problems can result is loss of vision in both eyes. Problems like low blood sugar, low blood pressure, blood loss, electrolyte imbalances. All of these would have also been ruled out in the hospital. Specific eye problems (like bleeding, stroke to the eyes, retinal detachment, inflammation) usually only affect one eye. She needs a good neurologic examination (I assumed that was done in the hospital). She also needs a good eye examination (I don't know if that has been done or not).


If all of these are normal, I must tell you (and you may not like to hear this) that the remaining diagnosis would be anxiety and/or hysterical vision loss (we call it physiologic vision loss).


Hope this helps.

Customer: replied 7 years ago.
This is what they are telling us, but it is hard to accept; particularly when we were just riding down the street after eating a fun lunch and running errands. Also, no one is saying how to treat it, what to do or how long it will last.

The whole family is getting stressed now. I just feel that there is a missed diagnosis somewhere.

Thanks for trying!!



After you have ruled out everything else, you are left with this. Physiologically, it is virtually impossible to lose total vision in both eyes simultaneously.


Symptoms of anxiety and/or conversion reaction usually cannot be predicted. These are not symptoms just from stress (that we all normally feel at times). These are real symptoms that have their cause in a psychologic condition. She really cannot see, but there is no structural damage to her eyes or brain. Psychologically, she cannot see.


How to treat it is more difficult. You can't just send the patient to see a psychiatrist. If they think that there is nothing wrong, that can be a turn off in terms of their healing. She needs lots of support and empathy. You may need to discuss this honestly with the doctors and try to come up with ways to help her. Find out what else is going on other than have her first baby (was there anything wrong with the last OB exam? is there friction or stress between her and the father? or his family? or your family? find out how she feels about being pregnant).


I sincerely XXXXX XXXXX you all find a solution.

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