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Ocular malingering: a surprising visual acuity test.

Michael H Graf1, Jens Roesen

  • 1Department of Ophthalmology, Strabismology, and Neuroophthalmology, University of Giessen, Friedrichstrasse 18, D-35385 Giessen, Germany. michael.h.graef@augen.med.uni-giessen.de

Archives of Ophthalmology (Chicago, Ill. : 1960)
|June 7, 2002
PubMed
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This study introduces a new visual acuity test to detect malingering and psychogenic visual impairment. The test effectively identified malingering in 74% of volunteers and 80% of patients.

Area of Science:

  • Ophthalmology
  • Visual Science
  • Psychology

Background:

  • Psychogenic visual impairment and malingering present diagnostic challenges.
  • Accurate identification is crucial for appropriate patient management and legal contexts.

Purpose of the Study:

  • To describe and evaluate a novel visual acuity test designed to identify psychogenic visual impairment and malingering.
  • To assess the test's efficacy in distinguishing genuine visual deficits from feigned ones.

Main Methods:

  • A 32-plate test featuring Landolt C optotypes with unpredictable sequences was developed.
  • The test incorporated interspersed circles after plate 21 to assess response consistency.
  • Performance was evaluated by comparing correct answer rates to binomial probability and analyzing responses to circles, administered to pseudomalingerers and suspected malingerers.

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Main Results:

  • The test successfully detected malingering in 14 out of 19 (74%) volunteers.
  • Malingering was identified in 12 out of 15 (80%) patients.
  • Detection was achieved through analysis of response accuracy and consistency, including reactions to interspersed circle stimuli.

Conclusions:

  • The developed visual acuity test is a valuable tool for detecting malingering.
  • The test can provide evidence of minimum visual recognition acuity, aiding in the assessment of genuine visual function.