Eye of the - emotional - storm.

Eye of the (emotional) storm

The 41-year-old carpenter had been, in his own words,"happily married." But then his wife unexpectedly spent the night out, eliciting in him a wave of rage and jealousy fueled by his certainty that she had had an affair. Two days after the traumatic incident, he lost the vision in one eye.

His eye problem was not "all in his had"--he had a disorderknown as central serous chorioretinopathy, in which vision is reduced because of detachment of the retina at the area of most acute vision. Although its causes are unknown, this problem predominantly occurs among men aged 30 to 50 years, and in most cases the retina reattaches and good vision returns after several weeks or months.

In a study of 33 people with central serous chorioretinopathy,including the aforementioned carpenter, researchers have found that 30 had a very distressing psychological experience in the hours or weeks preceding the first loss of vision. A marital crisis, loss of a lover or work crisis were most often reported in clinical interviews, say psychiatrist Gary S. Gelber and ophthalmologist Howard Schatz of the University of California at San Francisco. Among the 16 subjects who had high blood pressure and the 23 who had tension-producing personality traits such as extreme worrying, perfectionism and hostility, central serous chorioretinopathy sometimes followed only moderately distreessing episodes, they report in the January AMERICAN JOURNAL OF PSYCHIATRY.

Chronic high blood pressure or blood pressure jumps duringsuccessive incidents of stress may weaken capillaries near the retina and increase the likelihood of developing central serous chorioretinopathy, suggest the researchers.

Vision loss, they note, is not a direct result of the personalitytraits observed in some patients. The traits tend to stoke up daily tensions, emotional distress and physiological arousal. "These in turn may set in motion retinal vascular and blood pressure changes that predispose the individual to central serous chorioretinopathy," propose Gelber and Schatz.

Fifteen patients experienced recurrences of the eye problemseveral minutes to three days after new psychological disturbances, they add. The disturbances were not as severe, however, as those that had preceded the initial vision loss.