Citation:Incesu AI.Tests for malingering in ophthalmology.Int J Ophthalmol 2013;6(5):708-717,doi:10.3980/j.issn.2222-3959.2013.05.30
Tests for malingering in ophthalmology
Received:February 19, 2013  Revised:July 18, 2013
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Key Words:malingering  simulation  conversion  hysteria
Fund Project:National Nature Science Foundation of China (No.81170865)
Ali Ihsan Incesu Ministry of Health Konya State Hospital of Instruction Eye Clinic, Konya 42090, Turkey
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      Simulation can be defined as malingering, or sometimes functional visual loss (FVL). It manifests as either simulating an ophthalmic disease (positive simulation), or denial of ophthalmic disease (negative simulation). Conscious behavior and compensation or indemnity claims are prominent features of simulation. Since some authors suggest that this is a manifestation of underlying psychopathology, even conversion is included in this context. In today’s world, every ophthalmologist can face with simulation of ophthalmic disease or disorder. In case of simulation suspect, the physician’s responsibility is to prove the simulation considering the disease/disorder first, and simulation as an exclusion. In simulation examinations, the physician should be firm and smart to select appropriate test(s) to convince not only the subject, but also the judge in case of indemnity or compensation trials. Almost all ophthalmic sensory and motor functions including visual acuity, visual field, color vision and night vision can be the subject of simulation. Examiner must be skillful in selecting the most appropriate test. Apart from those in the literature, we included all kinds of simulation in ophthalmology. In addition, simulation examination techniques, such as, use of optical coherence tomography, frequency doubling perimetry (FDP), and modified polarization tests were also included. In this review, we made a thorough literature search, and added our experiences to give the readers up-to-date information on malingering or simulation in ophthalmology.
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