Misleading clinical stereoacuity levels in pediatric maculopathy

Because visual acuity and stereoacuity are assumed to be almost directly related, pediatric ophthalmologists and orthoptists may be inclined to compare them in cases of suspected functional visual acuity loss; good stereoacuity in the presence of reduced visual acuity frequently suggests a functional component. We report 3 cases involving pediatric maculopathy in which stereoacuity was relatively unaffected by reduced visual acuity. Along with the initial normal fundus appearance, which is frequently observed in pediatric maculopathy, good stereoacuity suggested functional visual acuity loss and delayed proper diagnosis in the first 2 cases. In the third case, visual-evoked potentials, electroretinography, and fluorescein angiography documented organic components; the eventual addition of a multifocal electroretinogram afforded a prompt diagnosis of maculopathy.