Certified Ophthalmic Medical Technologist (COMT) Practice Exam

What test could be performed to determine if a patient with a claimed monocular blindness is genuinely blind or malingering?

1. Visual fields test

2. Fixation or Ten-diopter base out test

3. Amsler grid test

4. Ocular motility test

The correct answer is: Fixation or Ten-diopter base out test

The fixation or Ten-diopter base out test is particularly effective in assessing whether a patient with reported monocular blindness is genuinely affected or possibly malingering. This test involves evaluating the patient's ability to fixate on a target while a lens is placed before the eye. In cases of true monocular blindness, the eye will not be able to fixate or respond to the stimulus appropriately. However, if the individual is feigning blindness, they may exhibit fixation or response during the test, indicating that vision may be intact. The other tests listed primarily assess different aspects of vision or ocular function, which may not directly imply the authenticity of monocular blindness. For instance, visual fields testing evaluates peripheral vision but does not necessarily confirm the presence of functional vision in the claimed blind eye. The Amsler grid test is used mainly for detecting macular issues and might not provide clear evidence regarding the functional status of the eye in question. Lastly, the ocular motility test assesses eye movement but does not evaluate visual perception. Therefore, the fixation or Ten-diopter base out test stands out as a specialized procedure conducive to discerning malingering in cases of claimed monocular blindness.