Neurological Emergencies in Pediatrics: acute visual loss

Key words: Acute blindness, Children, Functional visual loss, Non-organic disorder, Optic neuritis

Acute loss of vision in children is a worrying sign for both patients and physicians. In the absence of obvious ophthalmological signs, the paediatrician is faced with the challenge of distinguishing a functional (non-organic) disorder from potentially severe neurological abnormality. A high clinical suspicion is important to avoid the burden of unnecessary sophisticated diagnostic investigations. Detailed medical history with focus on preceding stressing events and a practical clinical approach, which aims to demonstrate physiological incongruities and that visual acuity is better than subjectively alleged, allow early diagnosis with important prognostic implications.