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March 1990

Functional Blindness in Photorefractive Keratectomy

Author Affiliations

Iowa City, Iowa

Arch Ophthalmol. 1990;108(3):318. doi:10.1001/archopht.1990.01070050016001

To the Editor.  —I read with great interest the exchange of letters between Drs Weinstein, Michaelson, and McDonald in the November 1989 issue of the Archives.1I believe we all have to agree that this case of functional blindness should have been easily diagnosed, even by a second-year resident.However, changing a previously accepted diagnosis requires a flexible mind and an intellectual effort, which we all find difficult to sustain when pressed for time. It is also possible (and here I am really leaning over backward) that a crushing patient load may prevent us from performing even the simple ancillary tests designed to make the patient think he or she is seeing with the left eye when it is the right eye that is really being used.It is, however, curious that the manuscript slipped through peer review. The reviewer must have been more concerned with technical details than

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