Patients with neuro-ophthalmologic sequelae of craniocervical and closed head injuries are among the most challenging and gratifying patients encountered in a neuro-ophthalmology practice. They often arrive at the neuro-ophthalmologist’s office unhappy and hostile, having seen an assortment of doctors who have been unable or unwilling to help them, or have tried to convince them that there is nothing wrong with them. The situation is muddied by lawyers trying to make money and insurance companies trying to save money. It is a fine balance of clinical judgement to determine which complaints are real, which are amplified and which are specious. It is best to examine these patients on several occasions with an open mind, treating their complaints as real unless they are proven contrived.