Thread by @Harry_Costello

During the 🧻 rush era of lockdown, while working at the brilliant #FND service @uclh, an #ophthalmologist 👁 (I happen to be married to) asked what services exist for all the patients with functional visual symptoms she saw?
Check out our paper: rdcu.be/czlbS
1/7

We surveyed 119 ophthalmologists nationally and asked about their experience, understanding and management of functional visual symptoms (FVS). 2/7

Disclaimer - I hadn’t seen FVS, thought it was rare, but it seems so did the rest of psych & neuro. Small case series had been published.

All the while ophth 👁 has been seeing FVS regularly. An estimated 5%-12% of cases in the busiest outpatient specialty in the UK. 3/7

Respondents estimated 3% of new patients had FVS & a 1/3rd presented with severe disability/impairment.
A broad spectrum of FVS were also reported, not just the tubular visual field defect seen in the 📚. 4/7

Only half of ophthalmologists felt comfortable discussing a diagnosis and 2/3rds felt they had inadequate training in this area. Free text comments highlighted a lack of time & space in clinic, and unclear/non-existent care pathways for patients. 5/7

So what happens to these patients?
Enduring symptoms were reported in 1/3rd of patients. Recovery rates in other papers are as low as 25%. Most are followed up in clinic (briefly) or discharged to GP.
Can they drive? Or be registered blind? Respondents were torn 🤷‍♂️. 6/7

I worry many patients with FVS fall through the cracks. 👁 pathways are needed. But given how common functional disorders, surely we need cross-specialty services offering the participatory, rehabilitative practice so eloquently described here: 7/7 bit.ly/3muDyzf