The Differentiation of the Ocular Manifestations of Hysteria and of Ocular Malingering

Hysterical Amblyopia

“…53 Hysterical amblyopia is usually bilateral, while the malingerer simulates loss of vision usually on only one side. Hysterics may give positive results on some of the malingering tests ; so one must not place too much faith in them.…”

Functional visual loss: I. A true psuchiatric disorder?

“…The clinical distinction between patients with unconscious non-organic visual dysfunction (functional visual loss) and patients with conscious non-organic visual signs which they use to obtain some obviously understandable goal (malingering) has been extensively discussed in the literature (Agatson, 1944;Brady, 1966;Deutsch, 1968;Downing, 1944;Drews, 1967;Hurst & Symms, 1919;Kramer et al 1979;Singhal, 1977;Spaeth, 1930;Unsworth, 1945;Yasuna, 1946). The clinical presentation can be the same for both.…”

“…The clinical presentation can be the same for both. Symptoms and signs thought to typify malingerers include: (1) improvement in visual acuity with tests designed to uncover normal acuity through trickery; (2) resentment of examination; (3) exaggerated 'blind' behaviour; (4) excessive worry about visual symptoms; (5) unilateral visual complaints; (6) highly non-organic visual fields-for example, binasal hemianopia with visual field defects on binocular field testing; and (7) no tubular or spiral visual fields (Drews, 1967;Spaeth, 1930;Yasuna, 1946). Though these signs and symptoms seem clear, the overlap is significant, making it difficult to separate the patients with functional visual loss from malingerers.…”

Psychogene Sehstörungen bei Kindern und Erwachsenen. Ophthalmologische, neurologische und psychodynamische Befunde*

“…In der älteren ophthalrnologischen Literatur stellen die psychogenen Sehstorungen -auch als psychogene oder hysterische Amblyopien bezeichnetem haufig beschriebenes Krankheitsbild dar (Spaeth, 1930;Stekel, 1934;Unsworth, 1945;Yasuna, 1946Yasuna, und 1951Schlaegel, 1955Schlaegel, und 1957. Derngegenuber sind die Mitteilungen darüber in den letzten Jahren eher spärlich (Kalthoff, 1968(Kalthoff, und 1976, obwohl neuere, technische Untersuchungsverfahren eine bessere Objektivierung vermuteter, nicht-organischer Sehstorungen ermoglichen.…”