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Pediatric ophthalmology: somatization or pretense

07/02/2019

I think my son is pretending that he can't see properly. What should I do?

If a child says that he can't see properly, you should ALWAYS take him to see a specialist, so that an ophthalmologist can assess the cause, make a diagnosis and advise on potential treatment.

After a visual acuity exam, optometric exam, and full check-up of the eyeball, it's possible that the ophthalmologist does not find an organic (physical) cause to explain the symptoms bothering the child. That’s when the physician needs to decide if complementary tests are necessary or if it’s a case of somatization—or pretending.

Children often complain of symptoms (stomachache, headache, blurred vision etc.) without a physical reason, but this is their way of outwardly expressing suffering, anguish or fear...

It’s very important to gain the patient's trust, that children see that we are listening to them and understand them. There will be signs that will make us suspect somatization, or that they are pretending, just by talking to them: what are these symptoms like, how long do they last, when do they occur, are they repeated, do they “go away” themselves... These questions will help us to figure out what the root of the problem is and see if another specialist is required.

In our daily consultations, we relatively frequently find cases of children who pretend or somatise: from a child who wants glasses because a schoolmate or a little  brother has just been born... and even in an attempt to cover up a case of bullying at school.

Dra. Ainhoa Martínez Grau

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