Functional visual loss

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.