Functional visual loss

Curr Opin Neurol. 2017 Apr;30(2):200-205. doi: 10.1097/WCO.0000000000000423.


Purpose of review: Functional visual loss (FVL) is a syndrome in which subjective visual parameters are inconsistent with objective measures. Recent advances in understanding the pathophysiology and management of functional disorders and FVL will be explored.

Recent findings: FVL requires a positive diagnosis of normal function through clinical examination or visual electrophysiology. A substantial proportion of patients have an underlying organic illness that needs to be identified and treated. Recent updates in Diagnostic and Statistical Manual of Mental Disorders-5 reflect the observation that many patients with FVL do not have a recognizable psychological association. A small number of functional neuroimaging studies suggest that there may be a stress-mediated prefrontal suppression of visual awareness. There is limited evidence to guide the treatment of FVL; education and reassurance remain first line, followed by cognitive behavioral therapy and pharmacotherapy for psychiatric comorbidities.

Summary: FVL remains a poorly studied and understood condition. Recent advances in the understanding and management of functional symptoms more generally may aid in advancing the understanding of this condition.

Publication types

  • Review

MeSH terms

  • Awareness
  • Cognitive Behavioral Therapy
  • Comorbidity
  • Functional Neuroimaging
  • Humans
  • Mental Disorders
  • Vision Disorders / diagnosis
  • Vision Disorders / physiopathology*