Malingering & Conversion Syndrome

malingering

• conscious, intentional action

• usually a child wanting attention &/or glasses

1. use stereo tests

2. test them with a pl lens, suggest it will help their vision & see if they say if it does

3. use R/G glasses & have them read the duochrome chart

4. take them to ½ the distance to the acuity chart & see if they read the same line as they were reading at the full distance (they should be able to read a lower line)

5. use a fogging lens (+10) and reduce until their acuity improves (ideally it will be around pl)

6. start w/ really small optotypes and work up to 20/20

7. show them a test that has a target that everyone can see

what are some ways to test for malingering?

conversion syndrome

reported cases in which children who have been through psychological trauma will have an apparently legitimate vision loss, non-intentional

no

can the tricks for determining malingering work for conversion syndrome?

1. significantly reduced VA w/o cause

2. reduced VF testing

3. signs that do not match function

what are the most common clinical findings for conversion syndrome?

tunnel vision, cloverleaf, reverse cloverleaf

what are the most common VF testing patterns for conversion syndrome?

malingering is intentional, conversion syndrome is not

what is the difference b/t malingering & conversion syndrome?

1. dx efficiently to avoid expensive testing & prompt needed tx

2. be suspicious when all objective testing is normal but subjective data is not

3. talk with the parent alone

what are some tips for handling conversion syndrome?

no (as soon as the mental health is better managed, the vision fully restores)

is conversion syndrome permanent?