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May 31, 2015 · 3. The blind spot indicates the location of the optic nerve head—an area with no photoreceptors—in the temporal part of the visual field. 4. Anything obstructing the travel of light towards the retina may affect the field tests, for example, lens opacity (cataract), ptosis (if not taped away from the pupil) or the rim of a correcting lens ...
- 1MB
- Sui H Wong, Gordon T Plant
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- 2015
- What Is Automated Perimetry?
- Which Subtest Should I Order?
- Reliability Indices
- Which Picture Do I Look at?
- How Do I Tell If Things Are Changing Over time?
- Top 5 Most Common Visual Field Patterns
- Conclusion
Here, we’ll only talk about the Humphrey visual field perimeter, which is used for 99% of visual field tests. It’s an automated, static perimeter (unlike Goldmann kinetic perimetry which requires a human operator, and uses a moving target). The Humphrey uses fixed points of light which are shown at different intensity levels. The software automatic...
HVF 24-2
This is ordered for 90% of glaucoma patients. This is your baseline exam that all glaucoma suspects and glaucoma patients need at routine intervals.
HVF 10-2
This is ordered for the 10% of glaucoma patients who are so advanced that the HVF 24-2 is mostly black, with only a central island of remaining vision. Macular diseases including plaquenil toxicity exams also need 10-2.
HVF 30-2
Generally, we order this for neuro patients. It has a wider angle and can capture peripheral field defects.
Name, demographics, etc: Make sure you are looking at the right patient!Fixation loss: The HVF will routinely flash dots in the patient’s physiological blind spot to check if the patient has his / her gaze fixated on the center. If the patient can actually see the spot...False positive: The user pressed the button when there was no stimulus. They were “trigger happy”. Reliable tests have below 33% false positives.False negative: The user did not see a stimulus which was brighter than one they saw earlier in the same test. Reliable tests have below 33% false negatives.Yes, there are a lot of graphs. The two most important to look at are the Grayscale Map and the Pattern Deviation. The rest of this article will explain how to interpret these.
This is the million dollar question. This is what every patient will want to know and how you will decide whether to step up drop therapy, add laser, or take the patient to the operating room. As a very, very general guideline, you can look at the density / size of the field defect, the pattern standard deviation, and the mean deviation (MD) to see...
1) Nonspecific / low Reliability / inattention / patient hungry
For every interpretable, reliable visual field you get, you will also get another in which the patient thinks he should be scanning the dome for lights the whole time, is poorly positioned, is exhausted from waiting in your clinic for hours, or is too elderly and arthritic to push the button in time. These types of inattention errors will usually register as high fixation losses, false positives, or false negatives. Or, the visual field could just be patchy all over. If these errors are not t...
2) Superior / inferior arcuate defect
The most common early to mid stage glaucomatous field. The reason these look like arcs and come off the blind spot is that they represent the loss of bundles of nerves as they come out of the optic nerve head. The horizontal border is the horizontal raphe, which is an imaginary line dividing the upper and lower hemispheres of the retina. These are probably 25%-35% of the fields we see.
3) Blind spot enlargement
This can be seen in glaucoma, but also can occur with papilledema and optic nerve head swelling. This would likely be seen in patients with idiopathic intracranial hypertension (aka pseudotumor cerebri).
Use this order to interpret your Humphrey visual field every time: 1. Confirm it’s the right patient with name and date of birth 2. Confirm it’s the right/left eye 3. Look at the reliability indices 4. Look at the pattern 5. Look at the GHT, mean deviation, VFI, and pattern standard deviation 6. Compare to the previous visual fields
Blind spot assessment occasionally features in OSCEs. This guide provides a step-by-step approach to assessing a patient’s blind spot. It also includes a video demonstration.
3 days ago · A visual field test can help diagnose scotomas, or blind spots. It can also help identify loss of peripheral or side vision. Loss of side vision is an indicator of glaucoma, a disease that can lead to blindness. This article describes what to expect during a visual field test, why it's done, and what the results mean.
Mar 7, 2020 · Fixation monitor: ‘Blind spot’. The machine works out where the person’s natural blind spot is and occasionally flashes a spot directly in it. If the patient is looking at the central fixation target (usually a steady central yellow light) they shouldn’t be able to see the flash in their natural blind spot.
Feb 10, 2024 · The test is operator- and patient-dependent, and the results shouldn’t be considered in isolation, physicians say. Here, glaucoma experts review the strengths and weaknesses of visual field testing, as well as provide their tips on interpreting patients’ fields.
People also ask
Should blind spot assessment be left unchanged?
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Aug 28, 2013 · Introduction. Wash your hands and don PPE if appropriate. Introduce yourself to the patient including your name and role. Confirm the patient’s name and date of birth. Briefly explain what the examination will involve using patient-friendly language. Gain consent to proceed with the examination. Position the patient sitting on a chair.
