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.