One Eye Sees, the other Feels

The title of this talk is taken from the writings of , the Swiss painter and diarist who eventually died of scleroderma. That ‘one eye sees, the other feels’ sums up the elaborate integration that exists between the external world and the mind. Perhaps Klee knew, or just guessed correctly, that the majority of the sensory input to the brain originates from the eyes, and, as Nietzsche stated, ‘all evidence of truth comes only from the senses’.

We have heard already how both eyes and their vision offer conduits for anxiety in the sentient being. The subject of this paper is ocular hypochondriasis. It is not one that has been well covered by ophthalmic writers. Somatic conditions—illnesses without physical basis—are easily recognised in patients at this and every other hospital. Little is made of their symptomatology, and almost nothing of their need.

For the benefit of the reader, a clinical example is useful.

Mrs Y was first seen at Moorfields Hospital in 1964, complaining of eyelid irritation. Over the next few years she subsequently presented with other complaints, but on each occasion was found to have healthy eyes. Her persistence was rewarded by examination and appraisal by many different specialists—neurologist, ophthalmologist, psychiatrist—but no foundation for her symptoms had ever been discovered. She continued to attend the Casualty department in this hospital, and has now been seen more than 350 separate times, occasionally twice in a day, and often on consecutive days.

Her GP writes:

… her problem is indeed a chronic anxiety-state with somatic anxiety and has presented through several guises not only related to her eyes but also to leukaemia, multiple sclerosis and Parkinson's disease as well as her apparent dental problem … she has been treated for chronic anxiety for over thirty years now and has been on Librium presumably since it was first introduced.

He goes on to discuss Mrs Y's further management, but concludes that her condition is complete