Functional Visual Loss Plus

The patient presented had a known organic disorder, pseudotumor cerebri, with a typical course of visual field progression, leading to optic nerve sheath fenestration. When the surgery failed to stop the progression, the functional nature of the visual loss was appreciated. Patients with underlying organic disease are perhaps the most difficult cases of functional visual loss to deal with. A case such as this one presents a two-edgedsword. On the one hand, unnecessary action may be taken with risk involved (surgery in this case). On the other hand, the diagnosis of functional visual loss may cause a delay in required treatment for the progressive organic component of the visual loss.