ReviewJournal of optometry2026
Diagnostic accuracy of objective measures for ocular malingering: A systematic review.
Review in Journal of optometry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo evaluate the diagnostic accuracy of objective tests including Visual Evoked Potentials (VEP), pupillometry, and eye-tracking technologies in detecting ocular malingering among individuals suspected of fabricating visual impairments for secondary gain.
methodsFollowing PRISMA guidelines, PubMed, Web of Science, Scopus, EMBASE, and Cochrane Library were searched until June 2025. Studies evaluating objective diagnostic methods for detecting ocular malingering that reported diagnostic accuracy metrics were included. Two reviewers performed data extraction and quality assessment using QUADAS-2.
resultsTen studies from 1993 to 2017 with 20 to 222 subjects were included. Approximately half of the studies employed experimentally simulated malingering paradigms, while the remainder involved clinically suspected cases. VEP was the most frequently evaluated modality and showed high sensitivity across studies, although specificity varied. Pattern-reversal VEPs showed effectiveness in adults and military conscripts, while step VEPs demonstrated 100% specificity in paediatric cases. Pupillometry and specialised colour vision tests achieved 80-94% sensitivity and specificity rates. Most studies showed low bias risk in index test and reference standard domains. These findings suggest potential utility of objective tools as adjuncts in clinical and medico-legal settings.
conclusionObjective diagnostic measures demonstrate promising utility as adjunctive tools for detecting ocular malingering and may support clinical decision making by providing reproducible assessments that bypass voluntary patient control. However, heterogeneity in study designs limits generalisability. Future research should standardise protocols and validate findings across diverse populations.
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