BACKGROUND: Body dysmorphic disorder is an excessive preoccupation with an imagined or slight physical defect that, in reality, is absent or minimal. The imagined defect can involve any body part, but the skin, hair, and nose are most common. Obsessive behaviors such as examination of the body part with a magnifying glass are common. This condition causes significant functional impairment and can lead to loss of employment and social isolation. Hospitalization for suicidal ideation is not uncommon. This disorder typically manifests during adolescence and affects men and woman equally. The prevalence of this condition is unknown, as many patients remain undiagnosed as they seek a "cure" by medical or surgical means.
CASE REPORT(S). A 52-year old white male with no significant history presented concerned about his facial appearance. Five months prior, the patient underwent removal of a conjunctival nevus. Subsequently, he developed an obsession with the appearance of his eyes, and complained of a reddened area he saw in the area of the excision, as well as swollen, inflamed lids, and dark circles around his eyes. Examination revealed no abnormalities. The patient returned three times in thirteen days and telephoned frequently concerned about the appearance of his eyes. The patient lost his job of 22 years and was homebound because of his obsession with his appearance. The patient was referred to psychiatry and was treated for body dysmorphic disorder.
CONCLUSIONS. Body dysmorphic disorder is a serious psychological condition that requires proper diagnosis and psychiatric treatment. Identification and management of these patients is important for Optometrists, as such patients may present with eye complaints.