Munchausen syndrome by proxy: Author reply

Abstract

I appreciate the fact that Dr Haddad read our case report describing a child with Munchausen syndrome by proxy, who presented with ophthalmologic findings.1Baskin D.E Stein F Coats D.K Paysse E.A Recurrent conjunctivitis as a presentation of Munchausen syndrome by proxy.Ophthalmology. 2003; 110: 1582-1584Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar Dr Haddad's erroneous notion that Munchausen syndrome cannot occur by proxy is exactly why we published the report! All physicians, including ophthalmologists, need to be aware of this condition. The term Munchausen syndrome by proxy was coined by Meadow in 1977.2Meadow R Munchausen syndrome by proxy. The hinterland of child abuse.Lancet. 1977; 2: 343-345Abstract PubMed Scopus (569) Google Scholar The original report stated: “parents who, by falsification, caused their children innumerable harmful hospital procedures—a sort of Munchausen syndrome by proxy.”The crime is committed by a caretaker, usually the mother, who achieves personal attention and/or psychologic gain. Like it or not, the term has achieved acceptable status in the medical literature. A search on PubMed identified 420 articles written about or referring to the topic since 1977. Despite frequent attention in other medical specialties, very little has been published in the ophthalmologic literature. Child abuse claims the lives of 3 children in the United States each day.3Thomas K Munchausen syndrome by proxy identification and diagnosis.J Pediatr Nurs. 2003; 18: 174-180Abstract Full Text PDF PubMed Scopus (23) Google Scholar The health care system is the first line of defense against Munchausen syndrome by proxy, and physicians of all types should be aware of this not so rare entity. I appreciate the opportunity once again to raise awareness in the ophthalmologic community about this important condition. I appreciate the fact that Dr Haddad read our case report describing a child with Munchausen syndrome by proxy, who presented with ophthalmologic findings.1Baskin D.E Stein F Coats D.K Paysse E.A Recurrent conjunctivitis as a presentation of Munchausen syndrome by proxy.Ophthalmology. 2003; 110: 1582-1584Abstract Full Text Full Text PDF PubMed Scopus (17) Google Scholar Dr Haddad's erroneous notion that Munchausen syndrome cannot occur by proxy is exactly why we published the report! All physicians, including ophthalmologists, need to be aware of this condition. The term Munchausen syndrome by proxy was coined by Meadow in 1977.2Meadow R Munchausen syndrome by proxy. The hinterland of child abuse.Lancet. 1977; 2: 343-345Abstract PubMed Scopus (569) Google Scholar The original report stated: “parents who, by falsification, caused their children innumerable harmful hospital procedures—a sort of Munchausen syndrome by proxy.” The crime is committed by a caretaker, usually the mother, who achieves personal attention and/or psychologic gain. Like it or not, the term has achieved acceptable status in the medical literature. A search on PubMed identified 420 articles written about or referring to the topic since 1977. Despite frequent attention in other medical specialties, very little has been published in the ophthalmologic literature. Child abuse claims the lives of 3 children in the United States each day.3Thomas K Munchausen syndrome by proxy identification and diagnosis.J Pediatr Nurs. 2003; 18: 174-180Abstract Full Text PDF PubMed Scopus (23) Google Scholar The health care system is the first line of defense against Munchausen syndrome by proxy, and physicians of all types should be aware of this not so rare entity. I appreciate the opportunity once again to raise awareness in the ophthalmologic community about this important condition.