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Research Letter
April 2014

Disablement-Based Nomenclature for Vision and Function

Author Affiliations
  • 1Wills Eye Institute, Philadelphia, Pennsylvania
  • 2Department of Psychiatry, Thomas Jefferson University, Philadelphia, Pennsylvania
  • 3Department of Neurology, Thomas Jefferson University, Philadelphia, Pennsylvania
JAMA Ophthalmol. 2014;132(4):505. doi:10.1001/jamaophthalmol.2014.154

Zhang et al1 recently reported that visual function loss but not visual acuity was associated with depression. In an accompanying editorial, Morse2 further described how the loss of functional vision (ie, actual task-related visual performance) leads to depression. The article and editorial raise important questions about the terminology of vision and function.

To explore understanding of these terms, we informally discussed the abstract with 20 ophthalmologist colleagues. Based solely on the abstract, 6 participants (30%) believed that the study focused on conversion symptoms (ie, a somatoform disorder). According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR), “The common feature of somatoform disorders is the presence of physical symptoms that suggest a general medical condition… and are not fully explained by a general medical condition, by the direct effects of a substance, or by another mental disorder.”3 Psychiatrists have replaced the term functional with the more specific DSM-IV-TR classification. Ophthalmologists appear to lack a clear sense of the term functional when describing vision and function.