Malingering and Secondary Gain in the Afghanistan and Iraq Conflicts (.pdf)

Functional or non-organic visual loss (NOVL) is defined as a loss or decrease in visual acuity or visual field range with no identifiable organic cause. NOVL can be a difficult diagnosis to make and requires a high index of suspicion. This can be especially difficult in the setting of true organic Pathology; as was the experience with several patients presenting to an Ophthalmology clinic after sustaining either ocular or non-ocular injuries. This case series examines several such patients with NOVL that were either injured or developed an ocular condition while serving in Iraq or Afghanistan. The aim of this series is to provide a review of several possible presentations of NOVL and the various modalities that the ophthalmologist can use to arrive at a diagnosis of NOVL.