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Club Jules Gonin

Distance doubling visual acuity test: A reliable test for nonorganic visual loss

Sebastian Martin Zinkernagel and Daniel Stephane Mojon

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Abstract

Background  

To determine the value of the distance doubling visual acuity test in the diagnosis of nonorganic visual loss in a comparative observational case series.

Methods  

Twenty-one consecutive patients with nonorganic visual acuity loss and 21 subjects with organic visual loss as controls were included. Best corrected visual acuity was tested at the normal distance of 5 meters using Landolt Cs. The patient was then repositioned and best corrected visual acuity was tested with the previous optotypes at double the distance via a mirror.

Results  

Nonorganic visual acuity loss was identified in 21 of 21 patients. Sensitivity and specificity of distance-doubling visual acuity test in functional visual loss were found to be 100% (CI; 83%–100%) and 100% (CI; 82%–100%), respectively.

Conclusion  

Distance doubling visual acuity test is widely used to detect nonorganic visual loss. Our results show that this test has a high specificity and sensitivity to detect nonorganic visual impairment.

Keywords  Nonorganic visual loss - Distance-doubling visual acuity test - Malingering - Psychogenic visual loss - Vision chart - Diagnostic techniques - Visual acuity

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