Functional Visual Loss in Adults and Children

Lim, Su Ann; Siatkowski, R. Michael; Farris, Bradley K.

doi:10.1016/j.ophtha.2005.05.009

Cited by 98 publications

(36 citation statements)

References 12 publications

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“…1,2,6,7 The clinician must have a high index of suspicion, which can be challenging in the setting of true ophthalmic pathology, and must not assume a diagnosis of NOVL until other organic diagnoses have been ruled out. The patients we describe underwent thorough evaluations, often by multiple providers on separate occasions as they progressed through the aeromedical evacuation system back to tertiary care facilities.…”

Section: Discussionmentioning

confidence: 99%

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Non-organic Vision Loss in the Afghanistan and Iraq Conflicts

Broderick

Ableman

Weber

et al. 2017

Neuro-Ophthalmology

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Non-organic visual loss (NOVL), defined as a decrease in visual acuity or field without an identifiable organic cause, can be challenging to diagnose, especially in patients whose NOVL is superimposed on some component of true organic pathology. Exposure to combat puts soldiers at risk of emotional distress and physical trauma, which can contribute to the development of NOVL with conversion disorder or malingering. This case series describes six patients with NOVL who sustained ocular or non-ocular injuries while serving in combat operations in Iraq and Afghanistan, and highlights diagnostic pearls and components of inter-disciplinary management in the unique military context. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 99%

“…1 It is a condition that can be found in both children and adults, with several reports citing an incidence of approximately 1.75% in children and 5.25% in adults presenting to the outpatient ophthalmology clinic. 2 NOVL can be a difficult diagnosis to make and requires a high index of suspicion. NOVL is time-consuming.…”

Section: Introductionmentioning

confidence: 99%

Non-organic Vision Loss in the Afghanistan and Iraq Conflicts

Broderick

Ableman

Weber

et al. 2017

Neuro-Ophthalmology

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“…The condition is most prevalent in the second and third decades of life. Females are predominantly affected [5, 6]. …”

Section: Introductionmentioning

confidence: 99%

“…However, for appropriate treatment it is important to distinguish between the two conditions. Moreover, it is essential to be aware that a significant number of patients with actual organic disease show functional overlay [5, 6]. This makes the evaluation of patients with NVL even more difficult.…”

Section: Introductionmentioning

confidence: 99%

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Stimulus Parameters for Goldmann Kinetic Perimetry in Nonorganic Visual Loss

Ebneter

Pellanda²,

Kunz³

et al. 2009

Ophthalmologica

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Objective: To investigate the influence of the stimulus parameters on perimetry at various distances and draw conclusions for the clinical exploration of nonorganic visual loss. Methods: Visual field testing using Goldmann kinetic perimetry was performed on 15 healthy volunteers. The I/1e isopter at 33 cm was compared to the I/1e, II/1e and I/2e isopters at 66 cm. The 0/1e isopter at 33 cm was compared to the 0/1e, I/1e and 0/2e isopters at 66 cm. Results: Doubling the examination distance without adjusting the stimulus parameters resulted in significant perimetric visual field constriction. Doubling the stimulus diameter resulted in perimetric visual field expansion by a factor of 2.26 and 3.32 for I/1e and 0/1e, respectively. Increasing stimulus luminance by a factor of 3.17 caused expansion by a factor of 2.15 and 2.32 for I/1e and 0/1e, respectively. Conclusions: To avoid falsely diagnosing visual field constriction, stimulus parameters need to be adjusted when visual field testing is performed at double distance. Increasing stimulus luminance was more appropriate than augmenting stimulus size.

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