Message from the Editor-in-Chief

Dear Colleagues,

In this issue of eye Insights, we take a close look at nonorganic vision loss (NVL). Inside, you’ll find techniques and tips for evaluating and managing patients with NVL.

It can be challenging and extremely time consuming to prove that a patient’s visual acuity potential is better than reported. It is important to keep in mind that approximately half of patients with NVL have objective examination abnormalities. Therefore, establishing the presence of NVL does not exclude other pathologies.

Patients with suspected NVL may be referred to a neuro-ophthalmologist when specific tests (e.g., Goldmann perimetry, tangent screen testing, optokinetic testing, or assessment of stereopsis) are necessary to confirm a diagnosis. However, effective management often requires coordination with primary care physicians and psychiatrists. Nationwide, there are about 200 full-time neuro-ophthalmologists. For a list of doctors who specialize in neuro-ophthalmology, please visit the website for the North American Neuro-Ophthalmology Society (nanosweb.org).

We hope you find this issue of eye Insights useful in your practice. Back issues are available online at masseyeandear.org. If you have questions or comments, please email us at eyeinsights@meei.harvard.edu.

Headshot of Joan W. Miller, MDJoan W. Miller, MD

David Glendenning CoganProfessor of Ophthalmology and Chair, Department of Ophthalmology, Harvard Medical School

Chief of Ophthalmology, Massachusetts Eye and Ear and Massachusetts General Hospital

Ophthalmologist-in-Chief, Brigham and Women’s Hospital