[Psychosomatic diseases of the eye--a review]

Abstract

After remarks on the uncritical use of the term "hysteria" in some investigations on psychosomatic phenomena in ophthalmology some recent reviews are presented, followed by the results of psychosomatic research on specific ophthalmological diseases. Dealing with glaucoma controlled studies are emphasized which attempt to determine the structure of neuroses and the importance of environmental situations. Using the MMPI high values on the scales 'depression', 'hypochondria' and 'hysteria' were observed. In previous attempts to influence glaucoma psychotherapeutically mainly autosuggestive and hypnotizing methods have been applied. The number of reported cases of psychogenic blindness has decreased considerably. We discuss, that it may not only be caused by the mechanism of hysterical conversion but also by a tendency to regression in schizoid neurotic structure. Concerning asthenopia and amblyopia the dependence of vision and visual acuity of the level of vegetative innervation is being accentuated; there appear to be correlations between certain errors of refraction and certain personality patterns. Psychiatric diseases may also influence vision: observations in paranoid and affective psychoses of later life and in schizophrenic children confirm it. This leads to the question, if schizoid neurotic structure can also be characterized by a specific disturbance in affective relations to sensations. Examples are given for investigations on other diseases (ablantio retinae, retinopathia centrales serosa), on the problem of self mutilation (auto-enuclation) and on neurophysiological question (psychogenic influences on pupil size).