Sight and blindness in the same person: Gating in the visual system

Psych J. 2015 Dec;4(4):178-85. doi: 10.1002/pchj.109. Epub 2015 Oct 15.

Abstract

We present the case of a patient having dissociative identity disorder (DID) who-after 15 years of misdiagnosed cortical blindness--step-by-step regained sight during psychotherapeutic treatment. At first only a few personality states regained vision whereas others remained blind. This could be confirmed by electrophysiological measurement, in which visual evoked potentials (VEPs) were absent in the blind personality states but were normal and stable in the seeing states. A switch between these states could happen within seconds. We assume a top-down modulation of activity in the primary visual pathway as a neural basis of such psychogenic blindness, possibly at the level of the thalamus. VEPs therefore do not allow separating psychogenic blindness from organic disruption of the visual pathway. In summary, psychogenic blindness seems to suppress visual information at an early neural stage.

Keywords: conversion disorders; dissociative identity disorder; lateral geniculate nucleus (LGN); psychogenic blindness; thalamus; visual evoked potentials (VEP, VECP); visual pathway.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blindness / physiopathology
  • Blindness / psychology*
  • Conversion Disorder / psychology
  • Dissociative Identity Disorder / complications*
  • Dissociative Identity Disorder / diagnosis
  • Dissociative Identity Disorder / physiopathology
  • Evoked Potentials, Visual / physiology
  • Female
  • Humans
  • Visual Pathways
  • Visual Perception / physiology*