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March 1990

Functional Blindness in Photorefractive Keratectomy-Reply

Author Affiliations

New Orleans, La

Arch Ophthalmol. 1990;108(3):318. doi:10.1001/archopht.1990.01070050016002

In Reply.  —We are certainly sorry that this case of functional blindness1 was not diagnosed prior to excimer laser treatment, and we fully appreciate Dr Blodi's point of view. In response, we offer the following information.The patient had two conditions that are more than capable of causing blindness: a pituitary lesion (and transsphenoidal hypophysectomy) and a retinal detachment in the eye in question.Her blindness had been confirmed by several independent ophthalmologists at three institutions during the 3-year period prior to her inclusion in the study. It is well documented that functional or hysterical blindness is usually bilateral and ordinarily resolves within a few days to a few weeks.2,3True functional blindness is exceedingly rare and allows the patient to pass "malingering" tests with flying colors; functional blindness is very different from malingering and cannot be detected in the same fashion. We performed several tests designed

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