Which visual field test is mostly reserved for malingering patients?

Which visual field test is mostly reserved for malingering patients?

• A. Amsler
• B. Central California Screener
• C. Kinetic Testing
• D. Tangent

Answer: (D)

The main idea here is that one visual field test is particularly suited to exposing non-organized or feigned loss of vision. The tangent screen perimetry maps the entire field using a fixed, large area and fixed stimuli, which invites careful observation of how a person detects targets across the field. In genuine organic disease, field loss tends to follow predictable patterns based on anatomy (for example, cutting across the retina or optic nerve pathways). With malingering, the responses often show unusual, non-physiologic patterns, inconsistencies, or responses that don’t line up with any known visual field defect. This makes the tangent screen especially useful as a tool to reveal inconsistent performance and non-organic loss. The other tests have important clinical roles but are not specifically designed to detect feigned deficits. The Amsler grid checks central vision and fixation and is more about monitoring macular function. The Central California Screener is a quick central-field screen, not aimed at uncovering deception. Kinetic testing maps the field with moving stimuli and is good for identifying true scotomas but doesn’t emphasize detecting malingering patterns as clearly as the tangent screen does.

The main idea here is that one visual field test is particularly suited to exposing non-organized or feigned loss of vision. The tangent screen perimetry maps the entire field using a fixed, large area and fixed stimuli, which invites careful observation of how a person detects targets across the field. In genuine organic disease, field loss tends to follow predictable patterns based on anatomy (for example, cutting across the retina or optic nerve pathways). With malingering, the responses often show unusual, non-physiologic patterns, inconsistencies, or responses that don’t line up with any known visual field defect. This makes the tangent screen especially useful as a tool to reveal inconsistent performance and non-organic loss.

The other tests have important clinical roles but are not specifically designed to detect feigned deficits. The Amsler grid checks central vision and fixation and is more about monitoring macular function. The Central California Screener is a quick central-field screen, not aimed at uncovering deception. Kinetic testing maps the field with moving stimuli and is good for identifying true scotomas but doesn’t emphasize detecting malingering patterns as clearly as the tangent screen does.