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Interdisciplinary approach to the treatment of rare visual illusions in a veteran
  1. Michelle Zeller1 and
  2. Wilhelmina Stamps2
  1. 1Department of Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
  2. 2Graduate School of Education and Psychology, Pepperdine University, Los Angeles, California, USA
  1. Correspondence to Dr Michelle Zeller; michelle.zeller{at}


Upside-down reversal of vision (UDRV) is a rare form of metamorphopsia, or visual illusions that can distort the size, shape or inclination of objects. This phenomenon is paroxysmal and transient in nature, with patients reporting a sudden inversion of vision in the coronal plane, which typically remains for seconds or minutes, though occasionally persists for hours or days, before returning to normal. Distorted egocentric orientation (ie, the patient perceives the body to be tilted away from the vertical plane) is even more rare as a co-occurring phenomenon. To the best of our knowledge, this is the first reported case of a veteran who presented with UDRV and distorted egocentric orientation during hospitalisation on an inpatient physical medicine and rehabilitation setting following an elective hip surgery. This case serves not only to document the presence of rare visual illusions, but also illustrates the importance and value of an interdisciplinary team approach.

  • hip prosthesis implantation
  • clinical diagnostic tests
  • neurology (drugs and medicines)
  • psychiatry (drugs and medicines)
  • rehabilitation medicine

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  • Contributors MZ is the guarantor and responsible for the overall content of the article, had the idea for the article and identified and managed the case. WS conducted the literature review and performed the neuropsychological assessment under MZ’s clinical supervision. MZ and WS wrote the article.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.