Visual Field Reduction in a 19-Year-Old: Causes and Concerns - Psychiatry

Intermittent visual field constriction?

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Hello Doctor, my son is 19 years old.
Since he was about 11, he has experienced episodes where his vision narrows after seeing graphic images that induce nausea (such as corpses or dissection scenes, but not other bloody or gory images like feces or gunfights).
During these episodes, his peripheral vision dims, and he can only see a small central area clearly (for example, while in a car, he can only see the size of the license plate in front of him).
He also experiences dizziness and sweating, which lasts for about 10 to 30 minutes before returning to normal.
This has occurred about once or twice a year since he was 11.
Last year, he visited an ophthalmologist at a medical center, where the doctor used office equipment to examine his eyes and concluded that there were no issues.
He has also seen psychiatrists and other ophthalmologists in the past, but none could provide an explanation.
Recently, I recalled that when he was 11, he fell while playing dodgeball at school one morning, landing on his buttocks and hitting the back of his head on the concrete floor.
That afternoon, the school informed me that he was not feeling well and had blurry vision when looking closely.
We then went to the emergency room, where the doctor conducted an initial examination and decided against an immediate CT scan, opting to observe him instead.
After resting in the emergency room for nearly two hours, he was eating normally and his condition improved, so the doctor prescribed pain medication and advised us to monitor him at home.
He experienced occasional tinnitus in the following 5-6 days but returned to normal afterward, and he gradually forgot about the fall.
I am unsure if the narrowing of his vision is related to this fall.
Note 1: My son cannot recall whether the symptoms of narrowed vision began before or after the fall.
Note 2: At the time, I did not intuitively connect it to the fall, as my son only mentioned the narrowed vision symptoms to me around the age of 13 or 14.
Note 3: My son's cognitive abilities do not seem to have been affected by the fall; aside from the occasional narrowed vision symptoms mentioned, he has had no other symptoms related to his brain, eyes, or elsewhere.
He is currently studying at National Changhua University of Education.
I would like to ask the doctor: 1) Based on your clinical experience, have you seen patients with similar symptoms? 2) Do these symptoms seem more related to a brain issue or an eye issue? 3) Is it likely that these symptoms were caused by the fall? 4) Nine years have passed, and my son tells me he has learned to control it well, meaning he closes his eyes when he anticipates seeing graphic images, so it has hardly occurred in the last 2-3 years (I recall it happening only once, when he was too engrossed in a novel and "thought" of a bloody, disgusting image).
However, as a concerned parent, I would like to know if it is sufficient to avoid looking at or thinking about graphic images to prevent episodes.
5) If you recommend that we find the cause, which specialty should my son see next? Does it need to be a large hospital with advanced brain examination equipment? 6) From a medical standpoint, over the past nine years, has there been no damage to his eye function due to this condition? If left untreated, is there a significant risk that it could lead to future eye function impairment? I apologize for the numerous questions, and I appreciate your understanding.
Thank you, Doctor.

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Jie, 50~59 year old female. Ask Date: 2022/07/18