Tests for Simulation of Monocular Blindness

  • Robert Enzenauer
  • William Morris
  • Thomas O’Donnell
  • Jill Montrey


An examiner can evaluate monocular blindness with many of the tests for binocular blindness performed with the good eye covered. There are also many tests for monocular blindness that depend upon both eyes remaining open. The examiner uses refractive dexterity, colored lenses and charts, and other maneuvers to create situations where the patient believes he is reporting on findings seen by his good eye when those findings can only be seen by a “seeing” bad eye. In addition, if a patient has high scores on Titmus Stereoacuity testing, the scores not only prove the presence of binocular vision but also correlate with definitive levels of Snellen visual acuity. Another method to demonstrate the presence of vision in the bad eye is to perform a bilateral visual field test using the Goldmann Perimeter. The functional patient’s guesses as to what a patient with true monocular blindness should see do not account for the normal overlap of the nasal visual fields and the resulting cover of the physiologic blind spot by that crossing portion of the visual field.


Monocular blindness Induced diplopia Maddox rod tests Prism reading test Refractive dexterity Colored lenses and charts Stereopsis tests Binocular visual field exam Tunnel vision Constricted visual field Fogging test Crossed cylinder test Worth 4 dot test 

Supplementary material

Video 9.1

Objective fixation_1 (MOV 139809 kb)

Video 9.2

Objective fixation_2 (MOV 139809 kb)

Video 9.3

Objective fixation_3 (MOV 140648 kb)

Video 9.4

Induced diplopia (MOV 261614 kb)

Video 9.5

Prism reading test (MOV 351557 kb)

Video 9.6

Fogging tests (MOV 173527 kb)

Video 9.7

Polarized lenses (MOV 210362 kb)

Video 9.8

Worth 4-dot test (MOV 173527 kb)

Video 9.9

“FRIEND” card (MOV 204724 kb)

Video 9.10

Goldman visual fields_1 (MOV 372270 kb)

Video 9.11

Goldman visual fields_2 (MOV 372270 kb)


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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • Robert Enzenauer
    • 1
  • William Morris
    • 2
  • Thomas O’Donnell
    • 2
  • Jill Montrey
    • 3
  1. 1.Department of OphthalmologyUniversity of ColoradoAuroraUSA
  2. 2.Department of OphthalmologyUniversity of TennesseeMemphisUSA
  3. 3.DenverUSA

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