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Testing for Functional Total Blindness

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Functional Ophthalmic Disorders

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Abstract

A patient with organic bilateral blindness rarely has a pupillary response to light, optokinetic nystagmus in response to the rotating striped OKN drum, an intact menace reflex, or blinking with strong focal illumination. The examiner should also observe the patient’s responses to obstacles in the walking pathway, ridiculous facial expressions, or a humorous or startling test card. Functional patients may guess the expected response of a blind person to requests to position hands or fingers with the eyes closed, but perform incorrect maneuvers because they do not understand that spatial orientation is still intact. In addition, a seeing eye has specific responses to various prism tests. There is a selective role for electrophysiologic testing with electroencephalograms, electroretinograms, visual evoked responses to visual stimulation, and galvanic skin reflex monitors.

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Author information

Authors and Affiliations

  1. Department of Ophthalmology, University of Colorado, Aurora, CO, USA

    Robert Enzenauer

  2. Department of Ophthalmology, University of Tennessee, Memphis, TN, USA

    William Morris & Thomas O’Donnell

  3. Denver, CO, USA

    Jill Montrey (Medical Writer/Editor)

Authors
  1. Robert Enzenauer
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  2. William Morris
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  3. Thomas O’Donnell
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  4. Jill Montrey
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8.1 Electronic Supplementary Materials

Below is the link to the electronic supplementary material.

Pupillary responses (MOV 209061 kb)

Optikinetic responses (MOV 501443 kb)

Mirror (MOV 200437 kb)

Threat/menace reflex (MOV 173527 kb)

Sudden strong illumination (MOV 137467 kb)

Observation (MOV 163648 kb)

Signature writing (MOV 191153 kb)

Obscenity startle card test (MOV 312890 kb)

Ridiculous facial expression (MOV 135214 kb)

Schmidt-Rimpler test (MOV 173527 kb)

Objective fixation_1 (MOV 139848 kb)

Objective fixation_2 (MOV 200412 kb)

Objective fixation_3 (MOV 151942 kb)

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Enzenauer, R., Morris, W., O’Donnell, T., Montrey, J. (2014). Testing for Functional Total Blindness. In: Functional Ophthalmic Disorders. Springer, Cham. https://doi.org/10.1007/978-3-319-08750-4_8

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  • DOI: https://doi.org/10.1007/978-3-319-08750-4_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-08749-8

  • Online ISBN: 978-3-319-08750-4

  • eBook Packages: MedicineMedicine (R0)

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