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October 1963

Most Missed Diagnoses

Arch Ophthalmol. 1963;70(4):446-447. doi:10.1001/archopht.1963.00960050448002

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Some 30 ophthalmologists known to have predominantly consultative practices were asked by us what constituted the most missed diagnosis. Selection of enquirees was done without benefit of statistical sampling and it is safe to assume the replies were submitted with similar abandon for statistical methodology. The validity of such a survey has therefore about as much reliability as table talk—but the responses may provide interesting conversation, if not unassailable authority.

Most significant, if not surprising, was the diversity of the replies. According to those whose practice was skewed toward neuro-ophthalmology the most missed diagnoses were amblyopia and field-constriction due to hysteria, and the ophthalmoplegias of myasthenia gravis and diabetes. Also stressed was the confusion of optic neuritis with the signs of parasellar tumor, and the specious diagnosis of papilledema where the true abnormality was drusen bodies within the disc.

To those surgeons oriented toward glaucoma, the most missed diagnoses were

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