An Increase in Functional Visual Loss: Another Side-Effect of the COVID-19 Pandemic?

Background: Functional visual loss (FVL), also known as Non-Organic Visual Loss (NOVL), is a condition characterized by visual impairment without an identifiable organic cause. FVL has been associated with psychological distress and psychiatric disorders, factors that were significantly impacted by the COVID-19 pandemic. This study aimed to assess the incidence of FVL before and after the COVID-19 pandemic and to explore potential underlying psychosocial factors contributing to its increase. Methods: We conducted a retrospective observational study at the University Eye Clinic, Milan, analyzing patient records from two six-month periods: pre-pandemic (January-June 2019) and post-pandemic (January-June 2023). We included patients aged 3-80 years old and collected their demographic, clinical, and ophthalmological data. Statistical analyses compared the FVL incidence rates and symptom prevalence across both periods. Results: The incidence of FVL significantly increased from 4.0% pre-pandemic to 9.1% post-pandemic (p < 0.001). Certain symptoms, such as eye irritation and luminous scotoma, showed significant changes post-pandemic. Pediatric patients demonstrated an increased tendency towards emulation behavior. Conclusions: The COVID-19 pandemic appears to have influenced the prevalence and characteristics of FVL, likely due to heightened psychological distress. Further research is needed to explore the long-term trends and intervention strategies.