Parents often ask me whether eye doctors can tell if a patient has real vision problems or if he or she is just trying to get glasses they don't really need. The answer is yes. I do occasionally see young patients who feign poor vision because they want to get glasses and making the distinction between those who actually need glasses and those who simply want glasses is pretty straight-forward.
Creating false complaints for the purpose of obtaining a certain reward is called malingering. Malingering may be done for the purposes of avoiding work or punishment or for gaining a desired outcome such as drugs, money, insurance benefits or even glasses (though false complaints about visual dysfunction to obtain glasses do not rank with the more serious abuses of the healthcare system).
The doctor's approach is never to discredit a patient. Rather, the approach is to make an accurate assessment of the patients' health and function. Malingering must be a diagnosis of exclusion, meaning a physician cannot determine that a patient is making false claims unless he or she has determined by thorough examination, that there is no basis for anything related to the patient's complaints. It is never a matter of guessing about a patient's motives.
If you are not sure what to do, err on the side of caution and have your child tested by an eye care professional. Vision screenings are great and the efforts of volunteers, school nurses and even pediatricians or other providers are commendable but even so, such screenings yield false positives and false negatives and are not equivalent to an examination by an eye care professional.
In cases where focusing problems in children can lead to permanent vision problems (a condition called amblyopia), intervention is essential and the sooner the better. Eye doctors use many different tests to determine visual function and measure focusing problems before making any diagnosis or prescribing corrective lenses. Though I do see the occasional malingering patient, most young patients come in because they have legitimate complaints about their vision and require corrective lenses or other treatment. And while their malingering peers may be disappointed when no glasses are prescribed, those who really need them generally appreciate the improvement in vision and upon follow-up, they and their parents have favorable reports citing improved performance in academics or sports, being less clumsy, cessation of headache symptoms and so forth.
Of all the things you are required do for your child, making a clinical diagnosis about his or her vision is not a call you have to make. Leave that to the eye doctor.
Creating false complaints for the purpose of obtaining a certain reward is called malingering. Malingering may be done for the purposes of avoiding work or punishment or for gaining a desired outcome such as drugs, money, insurance benefits or even glasses (though false complaints about visual dysfunction to obtain glasses do not rank with the more serious abuses of the healthcare system).
The doctor's approach is never to discredit a patient. Rather, the approach is to make an accurate assessment of the patients' health and function. Malingering must be a diagnosis of exclusion, meaning a physician cannot determine that a patient is making false claims unless he or she has determined by thorough examination, that there is no basis for anything related to the patient's complaints. It is never a matter of guessing about a patient's motives.
If you are not sure what to do, err on the side of caution and have your child tested by an eye care professional. Vision screenings are great and the efforts of volunteers, school nurses and even pediatricians or other providers are commendable but even so, such screenings yield false positives and false negatives and are not equivalent to an examination by an eye care professional.
In cases where focusing problems in children can lead to permanent vision problems (a condition called amblyopia), intervention is essential and the sooner the better. Eye doctors use many different tests to determine visual function and measure focusing problems before making any diagnosis or prescribing corrective lenses. Though I do see the occasional malingering patient, most young patients come in because they have legitimate complaints about their vision and require corrective lenses or other treatment. And while their malingering peers may be disappointed when no glasses are prescribed, those who really need them generally appreciate the improvement in vision and upon follow-up, they and their parents have favorable reports citing improved performance in academics or sports, being less clumsy, cessation of headache symptoms and so forth.
Of all the things you are required do for your child, making a clinical diagnosis about his or her vision is not a call you have to make. Leave that to the eye doctor.
