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Diagnostic work-up should include patient observation, detailed history, pupillary examination, dilated ophthalmoscopy, visual field testing and ganglion cell analysis of the macular complex. Most common organic mimickers of FVD are amblyopia, cortical blindness, retrobulbar optic neuritis, cone dystrophy and chiasmal tumours; however, all could be ruled out by structured diagnostic approach. For patients with unilateral visual loss, bottom-up refraction, fogging of the well-seeing eye in the phoropter, convex lens and base-down prism tests could aid in diagnosis. For patients claiming binocular vision loss, checking for eye movement during the mirror test or nystagmus elicited by an optokinetic drum can be helpful. Effective management of FVD involves reassurance, stress reduction and, if agreed on, management of comorbid anxiety and\/or depression. The social cost of FVD is predominately economic as patients typically meet several healthcare providers over multiple visits and often undergo several neuroimaging studies before neuro-ophthalmology referral. Further, inappropriate granting of disability benefits confers additional stigma to patients with organic vision loss.<\/jats:p>","DOI":"10.1136\/bjo-2023-324856","type":"journal-article","created":{"date-parts":[[2024,2,2]],"date-time":"2024-02-02T18:25:15Z","timestamp":1706898315000},"page":"1479-1485","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Functional vision disorder: a review of diagnosis, management and costs"],"prefix":"10.1136","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7069-3162","authenticated-orcid":false,"given":"Brendan Ka-Lok","family":"Tao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jim Shenchu","family":"Xie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6738-7225","authenticated-orcid":false,"given":"Edward","family":"Margolin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,2]]},"reference":[{"key":"2025040502501459000_108.11.1479.1","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.survophthal.2021.03.002","article-title":"Functional vision disorders in adults: a paradigm and nomenclature shift for ophthalmology","volume":"67","author":"Raviskanthan","year":"2022","journal-title":"Surv Ophthalmol"},{"key":"2025040502501459000_108.11.1479.2","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1146\/annurev-clinpsy-032813-153639","article-title":"The cycle of classification: DSM-I through DSM-5","volume":"10","author":"Blashfield","year":"2014","journal-title":"Annu Rev Clin Psychol"},{"key":"2025040502501459000_108.11.1479.3","unstructured":"American Psychiatric Association . 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