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Approach to “Visual Loss”
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Aastha Takkar Kapila, Monika Singla, Vivek Lal
Nonorganic (functional) visual loss can present with persistent monocular vision loss and is more common among younger age groups. Frequently reported non-organic visual complaints include a reduction of visual acuity with or without loss of field.14 Vague history of onset, profound monocular visual loss with inconsistent or bizarre responses on vision testing, normal pupil function and ocular structures, known psychiatric or behavior disorders are often found in these patients. Clues to diagnose a patient of functional/non-organic visual loss are given in Table 4.3.
Programme choice
Published in Fiona Rowe, Visual Fields via the Visual Pathway, 2016
A further indication for kinetic perimetry is for patients with functional visual loss. Functional visual loss may be purposeful (malingerers) or psychological in which the patient truly believes that there is a problem with their vision. Visual field defects that are pathognomic of functional loss include spiralling isopters, cross-over of isopters and severely constricted fields. Full investigation of these cases reveals no organic cause for visual field loss.
Introduction to Glaucoma
Published in Neil T. Choplin, Carlo E. Traverso, Atlas of Glaucoma, 2014
Neil T. Choplin, Carlo E. Traverso
In spite of the broad range of treatment modalities available, the prognosis of the glaucomas is variable and reflects the broad scope of underlying etiologies. A myopic male patient with onset of pigment dispersion glaucoma in his 40s has a much better prognosis than the patient with absolute glaucoma as the result of an ischemic central retinal vein occlusion, and complete angle closure from iris neovascularization POAG is the most common type of glaucoma and has a fairly good prognosis in most cases if the diagnosis is made before reaching an advanced stage. Delay in diagnosis can lead to blindness or significant visual disability. The risk of functional visual loss is of even greater concern, given the ever-lengthening average life expectancy of our patients, particularly for those presenting with advanced disease at a relatively young age.
An interesting case of functional visual loss presenting as a left homonymous hemianopia
Published in Clinical and Experimental Optometry, 2021
Functional visual loss refers to the loss of vision that cannot be assigned to a pathological or structural source and is commonly related to psychological issues.1,2,9,10 There are three major categories of functional disorders: (1) somatoform disorders (also commonly referred to as ‘hysteria’), (2) factitious disorders, and (3) malingering. In general, malingering implies purposeful feigning or exaggeration of symptoms usually for clear secondary gain, while somatoform disorders are thought to occur outside the patient’s conscious awareness.11