眼可受全身系统性疾病的累及,通过眼部表现可对心血管系统性疾病、神经系统疾病、自身免疫性疾病、感染性疾病及药物相关眼病等全身疾病进行评估、协助诊断和随访观察。重视全身疾病在眼部的表现,对于眼科及相关专业临床诊疗水平的提升具有重要意义。
Eyes can be affected by systemic diseases. Ocular manifestations can be used to evaluate, help to diagnose and observe systemic diseases including cardiovascular diseases, neurological disorders, autoimmune diseases, infectious diseases and drug-related eye diseases. Paying attention to the manifestations of systemic diseases in the eye is of great significance for the improvement of clinical diagnosis and treatment in ophthalmology and related specialties.
非器质性视力下降也称为心因性或功能性视力下降,除视力下降外,还可伴有视野缺损,多由于精神心理疾患导致的转换障碍引起,部分患者为诈病以获取利益。本文报道1例6岁的女性患者,主诉双眼反复视力下降1年余,早期被误诊为儿童视神经炎,给予糖皮质激素冲击治疗,治疗后稍有好转。通过本例患者误诊的教训,提醒我们在遇到儿童出现不明原因的视力下降时,在没有明确器质性疾病证据时要想到非器质性视力下降的可能,掌握识别非器质性视力下降的检查方法,不能忽略相对性传入性瞳孔障碍等基础的神经眼科检查。
Non-organic vision loss is also known as psychogenic or functional vision loss. In addition to vision loss, it can also be accompanied by visual field defect. It is mostly caused by conversion obstacles caused by mental and psychological diseases. Some patients cheat to obtain benefits. This paper reports a 6-year-old female patient who complained of repeated visual acuity decline for more than one year. She was misdiagnosed as pediatric optic neuritis in the early stage and was treated with glucocorticoid shock therapy, which her condition improved slightly after treatment. The misdiagnosis of this patient teaches us that when children have unexplained visual acuity decline, we should think of the possibility of non-organic visual acuity decline when there is no clear evidence of organic diseases, master the examination methods to identify non-organic visual acuity decline, and cannot ignore the basic neuro-ophthalmic examination such as relative afferent pupillary defect (RAPD).
非器质性视力下降也称为心因性或功能性视力下降,除视力下降外,还可伴有视野缺损,多由于精神心理疾患导致的转换障碍引起,部分患者为诈病以获取利益。本文报道1例6岁的女性患者,主诉双眼反复视力下降1年余,早期被误诊为儿童视神经炎,给予糖皮质激素冲击治疗,治疗后稍有好转。通过本例患者误诊的教训,提醒我们在遇到儿童出现不明原因的视力下降时,在没有明确器质性疾病证据时要想到非器质性视力下降的可能,掌握识别非器质性视力下降的检查方法,不能忽略相对性传入性瞳孔障碍(relative afferent pupillary defect,RAPD)等基础的神经眼科检查。
Non-organic vision loss is also known as psychogenic or functional vision loss. In addition to vision loss, it can also be accompanied by visual field defect. It is mostly caused by conversion obstacles caused by mental and psychological diseases. Some patients cheat to obtain benefits. This paper reports a 6-year-old female patient who complained of repeated visual acuity decline for more than one year. She was misdiagnosed as pediatric optic neuritis in the early stage and was treated with glucocorticoid shock therapy, which her condition improved slightly after treatment. The misdiagnosis of this patient teaches us that when children have unexplained visual acuity decline, we should think of the possibility of non-organic visual acuity decline when there is no clear evidence of organic diseases, master the examination methods to identify non-organic visual acuity decline, and cannot ignore the basic neuro-ophthalmic examination such as relative afferent pupillary defect (RAPD).