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Various writers have found that micropsia in hysterics, schizophrenics, and other patients results from a compromise between the patient's aggressive tendencies and the defense against them. It may also be the sign of defensive antipathy to objects, and it may have other meanings. Lewy treated a seventeen-year-old boy in whom the symptom occurred during several psychotic episodes while he was in analysis. Early traumas had produced severe oral fixations. Optical experiences are often linked with oral problems: such patients seem unable to believe and to consider real what they can only see but not feel, taste, or smell. Where there is deep insecurity, optical perception is less reassuring than the other modalities of perception. In this patient, micropsia appeared when the ego was threatened with inundation by the id. The symptom may have several meanings. The most plausible is that 'seeing things small' means a loss of contact with reality due to withdrawal of cathexis. Small objects are remote objects. An ego that begins to feel small may project this feeling onto outer objects. Reducing the size of objects may also serve to make them less terrifying. Lewy stresses the possibility that micropsia was an attempt to stave off by projection feelings of estrangement from the self, and that it also resulted from withdrawal of libido from objects. In the development of the symptom there is revived a very primitive stage of ego development at which differentiation between the individual and the outer world has not yet been clearly made. To understand the phenomenon one must examine the functions of the ego, especially endopsychic perception.