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Related Experiment Videos

Practical clinical approaches to functional visual loss.

Celia S Chen1, Andrew W Lee, Arthur Karagiannis

  • 1Department of Ophthalmology & Visual Sciences, University of Adelaide, North Terrace, Adelaide, South Australia, Australia. celiachen@bigpond.com

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|May 30, 2006
PubMed
Summary

Functional visual loss (FVL) is diagnosed using specific clinical tests, avoiding expensive imaging. Early, confident diagnosis and understanding management are key for patient recovery.

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Area of Science:

  • Ophthalmology
  • Neurology
  • Psychiatry

Background:

  • Functional visual loss (FVL) presents as subnormal vision without identifiable pathology.
  • It exists on a spectrum from malingering to hysteria.
  • FVL can impose significant financial burdens due to evaluation and disability claims.

Purpose of the Study:

  • To offer a practical approach for examining patients with suspected functional visual loss.
  • To guide clinicians in accurate and early diagnosis of FVL.
  • To reduce diagnostic costs by emphasizing clinical tests over imaging.

Main Methods:

  • High index of suspicion is crucial for initial assessment.
  • Performance of a few simple, well-learned clinical tests.
  • Avoiding unnecessary expensive imaging like MRI.

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Main Results:

  • Simple clinical tests can demonstrate vision better than alleged.
  • Effective clinical testing can obviate the need for costly investigations.
  • Properly applied tests can significantly reduce diagnostic costs.

Conclusions:

  • Accurate and early diagnosis of FVL relies on clinical suspicion and specific tests.
  • Management should be empathetic, as confrontation is rarely effective.
  • Emphasizing a good prognosis facilitates patient recovery and offers a positive outlook.