The fourth case is a 30-year-old woman who reported visual loss after refractive surgery with LASIK one year earlier.
The patient's personal history included a doubtful diagnosis of multiple and dubious malformations performed 20 years ago with no evidence of image.
On examination, the patient had a vision of 0.05 and hand movement.
The surgical flap showed no alterations.
When examining the bottom of the eye, the presence of myelin fibers in the right optic nerve and mildness in the left were observed.
The suspicion of malingering arises when it was observed that the patient unfolds perfectly in the consultation, sending a message with her mobile.
She works and leads despite her supposedly low vision.
The examination that performed binocular vision and stereopsis were normal (120"-60).
Specific tests such as Bravais and writing or Roth were positive.
The patient was able to write her name with monocular vision and following a line, despite interrupting it in the middle of the task.
He also drawn a straight line, resuming the trace at the point where he had left it after intentionally distracting it.
Complementary tests such as the AFG and the Establishment Order provided results within normal limits.
In VEP there was a slight decrease in conduction in the left optic nerve.
The neurology service ruled out multiple sclerosis, with normal MRI and lumbar puncture.
