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Minerva Medicolegale 2017 December;137(4):92-102

DOI: 10.23736/S0026-4849.18.01772-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: Italian

Morpho-functional relationships in evaluating low vision

Filippo CRUCIANI 1, 2, Roberto PERILLI 3 , Federico MARMO 4, Daniele RODRIGUEZ 5

1 Agenzia Internazionale per la Prevenzione della Cecità (IAPB), Rome, Italy; 2 Polo Nazionale per la Riabilitazione Visiva, Gemelli Policlinic, Rome, Italy; 3 UOSD Territorial Social Ophthalmology, AUSL Pescara, Pescara, Italy; 4 Italian Army, Rome, Italy; 5 University of Padua, Padua, Italy


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In Italy, eligibility for Social Security low-vision benefits is ruled by Law 138/2001, defining two classes of blindness and three classes of low vision, only based on the evaluation of visual acuity and visual field, subjectively provided by the examinees. A long series of litigations between examinees and the National Institute for Social Security (INPS) has been ensuing since such ruling, and recently the “fake-blind” phenomenon has gained the mass media’s attention. In this paper, the Authors propose the adoption of a clinical-instrumental evaluation pathway, integrating the subjective performance of the examinee, based on the objective relationship between specific morphology of the suffering structures and visual function, thus integrating or denying the subjective parameters provided by the examinees. Such morpho-functional relationship is strongly supported by the huge international production of controlled clinical, instrumental, pharmacological and surgical studies, providing a precise correlation between visual acuity and/or field in definite pathologies, obtained from non-simulating patients and in accordance with the internationally accepted rules of evidence-based medicine.


KEY WORDS: Blindness - Vision, low - Social security

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Publication History

Issue published online: March 26, 2018
Manuscript accepted: February 19, 2018
Manuscript received: February 6, 2018

Cite this article as

Cruciani F, Perilli R, Marmo F, Rodriguez D. Il rapporto tra residuo funzionale e menomazione anatomica nella valutazione della disabilità visiva. Minerva Medicoleg 2017;137:92-102. DOI: 10.23736/S0026-4849.18.01772-8

Corresponding author e-mail

roberto.perilli@ausl.pe.it