Feigned Visual Loss Misdiagnosed as Occult Traumatic Optic Neuropathy: Diagnostic Guidelines and Medical-legal Issues

The medical–legal problem of occult traumatic optic neuropathy diagnosed in patients who actually have feigned visual loss (malingering) is reviewed along with guidelines for suspecting and differentiating feigned visual loss from true traumatic optic neuropathy. We explain why we feel the term occult optic neuropathy is inappropriate and misleading, and the medical–legal consequences of this misdiagnosis are discussed.