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August 1959

Bilateral Central Scotomas of Hysterical Origin

Author Affiliations

New York
From the Department of Ophthalmology, New York University-Bellevue Medical Center.

AMA Arch Ophthalmol. 1959;62(2):273-279. doi:10.1001/archopht.1959.04220020099014

Since publication by Lincoff and Ennis,1 in 1956, of a case of bilateral central scotomas in a hysterical child, two similar cases have been treated by the eye service at New York University-Bellevue Medical Center. A study of these cases has led to the conclusion that the syndrome of bilateral central scotoma of acute onset in the absence of visible ocular pathology, toxic symptoms, or a family history of hereditary blindness is probably hysterical in origin.

The diagnosis of bilateral retrobulbar neuritis has always seemed unsound, for it is most unlikely that the discrete lesions of demyelinating disease will select simultaneously the axial portions of the separate optic nerves. While a single lesion in the chiasm can do this, a lesion so placed is distinguished by temporal hemianopic features. It is sometimes argued that the defect is only bilateral and simultaneous in its recognition, that the lesion in one

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