The only explanation for the presented case is an Accomodative astenopia in other words, if the patient has really a mild Myopia 2.0 and had an excessive near work -cell phone, computer, etc. and nervous system instability the power of Myopia increased due to contraction of the cilliary body adding Diopters and Phychotherapy intended to relax the nervous system neutralise  ciliary body contraction decreasing diopters till the Objective power of Myopia, which was equal to 2.0D for this patient.

Eyesight can change dramatically and quickly during hypnosis.  Also during multiple personality disorders it is quite possible for the different personalities to have differing vision abilities and prescriptions.

What an interesting question Marita. I would consult with an opthalmologist as to the possible causes of this spontaneous improvement in myopia. I could understand a deterioration, but I find this very curious, but I  do not know the possible underlying pathology.

Although there is a mind-body connection, I think it important not to always assume the connection with psychotherapy. Since I work with patients living with chronic diseases, I am perhaps more sensitive about the mind-body connection and where sometimes what happens is physical and not psychological. Therefore, I would always consult with an opthalmologist "to see" if there is a medical explanation.

Nevertheless, psychoanalysis can allow us "to see" things differently (and for us "to see" ourselves differently) and therefore your question about the psyche-soma is most intriguing.

Thank you Rosalind for your interest. I did really consult him, but there was no answer. I believe I have an, I simply asked the patient to try to look at me, because she never did it. So she began to try, then that change began to happen.

I thought you would! It is very intriguing because one can either see or not see.

I would love to learn more about your patient but clearly that might not be possible here. Perhaps you could write a paper?

• Yes one can but all that change in quite a short time suprized me.
• Thank you Marianne and Mathew, that was new for me! The patient had gone with her minus 10 spectacles in 15 years!

I have not encountered such a dramatic change and not within such short time phase, but I have seen 3 patients reporting increased eye sight (from 1.25/5 down to 0.75/1.00) in their regular yearly check-up. Two opticians I spoke to related it with potential decreased stress and anxiety.

My patient had avoided seeing an ongoing insestous  relation her husband had to their very young daughter. Now she had to take care of the girl and to get distance to the husband. Her passivity had to change. It was difficult .

Thanks to Marianne, I have been reading about accomodative astenopia and I can "see" how this diagnosis fits with Marita's understanding of her patient. It is, I think, a metaphor for the patient's refusal to "see" her husband's incestuous relationship with their youngest daughter. No mother would want to "see" this and thus this "symptom" was the result. This reminds me of Freud's writings in that the "passivity" ie her refusal to acknowledge reality, is converted into this symptom. When she was helped by Marita, to see the incest, her symptoms decreased with her capacity to see.

I am sure you can formulate this better than I, Marita.

Thank you Marita for a fascinating account.

Thank you all for your interest.This is psychosomatics as it's most may be simplest explanation. A similar thing probably could be an attach of headache or intestine ulcer which quickly disapier during therapy. Some therapist sand even analysts give pills for headache during the therapy instead of analysing it.