Visual field in hysteria-reliability of visual field by Goldmann perimetry

Abstract

Four cases with hysterical amblyopia in youngsters under 15-year-old showed the poor reproducibility of visual field, that is, when the same target was moved from the periphery toward the fixation ten times along the same meridian during the same examination, the position of the plotted points were rather variable. The range of variation was measured from the innermost point to the outermost one, after the two first points were omitted because points first detected were usually far from the others. The variation of cases measured by this method was compared with that of normal persons. Results were as follows; 1. in normal person, the mean value of its range was 5.5 degrees in first decade and 4.2 degrees in second to seventh decade; 2. patients with psychogenic visual disturbances showed a variability of 14.2 degrees, and this was significantly different from normal (p less than 0.01). These results suggest that this convenient method was helpful for diagnosis of hysteria. It should also be remembered that when we evaluate the visual field, changes under 4 degrees are probably not significant.

Critical Perimetry – Functioning Methods

“…These saccades are often followed by an immediate saccade back to the primary position. The large number of premature saccades which could be triggered even in ophthalmologically trained test persons 6 Ophthalmologica 1999;213: [3][4][5][6][7] Graef/Wassill within only 16 stimulus applications shows that this is a promising strategy to control dubious perimetric findings. It is certainly the method of choice in critical perimetry because, in contrast to the other strategies, it yields valuable information about the factual visual field outside the subjectively claimed isopters.…”

“…It is a banality that also in manual perimetry performed by a non-sensibilized perimetrist the psychogenic origin of visual field loss can easily be missed [2]. A sensibilized observer should be able to detect psychogenic visual field defects quite reliably by manual perimetry [3,4]. The clinical reality, however, shows that a critical control of pretended visual field loss is frequently neglected, even if the perimetry was performed within the scope of ophthalmological expertises [5].…”

Practical clinical approaches to functional visual loss

“…5c). [21][22][23] The binocular visual field versus the monocular field can also help demonstrate FVL. In those with alleged monocular decreased visual field, map out the field defect.…”

Neuro-Ophthalmologic Manifestations of Psychogenic Disease

“…Alternatively, the visual field may remain the same size or nearly the same size regardless of the size or brightness of the test stimulus, or it may be inconsistent when tested repeatedly in one or more meridians. 23 When the field is tested with automated static perimetry, the seeing area may have a square or cloverleaf appearance (Fig. 5B).…”