Distance doubling visual acuity test: a reliable test for nonorganic visual loss

Zinkernagel, Sebastian Martin; Mojon, Daniel Stephane (2009). Distance doubling visual acuity test: a reliable test for nonorganic visual loss. Graefe's archive for clinical and experimental ophthalmology, 247(6), pp. 855-8. Berlin: Springer-Verlag 10.1007/s00417-008-1019-9

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BACKGROUND: To determine the value of the distance doubling visual acuity test in the diagnosis of nonorganic visual loss in a comparative observational case series. METHODS: Twenty-one consecutive patients with nonorganic visual acuity loss and 21 subjects with organic visual loss as controls were included. Best corrected visual acuity was tested at the normal distance of 5 meters using Landolt Cs. The patient was then repositioned and best corrected visual acuity was tested with the previous optotypes at double the distance via a mirror. RESULTS: Nonorganic visual acuity loss was identified in 21 of 21 patients. Sensitivity and specificity of distance-doubling visual acuity test in functional visual loss were found to be 100% (CI; 83%-100%) and 100% (CI; 82%-100%), respectively. CONCLUSION: Distance doubling visual acuity test is widely used to detect nonorganic visual loss. Our results show that this test has a high specificity and sensitivity to detect nonorganic visual impairment.

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