Prevalence of organic Neuro-ophthalmologic dieae in patient with functional viual lo

Purpoe To determine the concurrence of variou pattern of functional viual lo (FVL) and organic dieae. Deign A retropective cae erie in a univerity neuro-ophthalmology practice. Method A retropective cae erie in which we reviewed the clinical hitorie and neuro-ophthalmologic examination of 133 conecutive patient diagnoed with FVL between July 1999 and Augut 2001. Functional viual lo wa defined a an apparent afferent or efferent dyfunction that wa unaociated with or far out of proportion with an identifiable leion of the viual pathway. Reult A total of 133 patient were identified. Nineteen were pediatric, and 76 were female. Fifty-ix had concurrent head or eye pain. Nineteen had a recent hitory of trauma, and 17 had a recent urgical procedure. The mot common pattern of FVL wa a normal viual field in the preence of reduced viual acuity. eventy-one patient (53%) with FVL preented with abnormal neuro-ophthalmologic examination. Thirteen patient had central cotomata, and all had concurrent retinal or optic nerve pathology. Only 18 patient had a known diability claim pending. Concluion Although FVL wa found in patient with no pathology, it wa more common to find objective abnormalitie on examination. Thi concurrence rate undercore the clinical neceity for following patient cloely depite the diagnoi of FVL. No pattern of viual field contriction wa routinely predictive of ophthalmologic or neurologic pathology except the preence of a central cotoma. The preence of a central cotoma in a nonorganic viual field hould alert the practitioner to earch for organic pathology