This document provides guidance on interpreting visual field tests. It outlines the key steps which include checking patient and test data, obtaining a general impression, observing defects and curves, and reviewing statistics. Various plots and indices are described that analyze retinal sensitivity values, compare them to normal values, and evaluate for abnormalities. Global indices like mean deviation and pattern standard deviation reduce the field data into single numbers. The reliability and quality of the test are also important to evaluate. Factors like eye conditions, testing procedures, and artifacts can influence results.

1. INTERPRETATION
FIELDS
OF

2. APPROACH
1
Check patient and
test data
2
Obtain general
impression
3
Observe defects
and defect curve
4
Review statistics
PATIENT DATA
GREY SCALE
COMPARISONS
TDNP
TEST DATA
VALUES
RAW DATA
BABIE’S CURVE
CORRECTED COMPARISONS
PDNP
PROBABILITY
TDPP
GLOBAL INDICES
CORRECTEDD PROBABILITY
PDPP

3. WANDER
 What was done?
 Accuracy (Reliability)
 Normal or abnormal
 Defect pattern
 Evaluate compatible disease
 Review

4. PATIENT DATA
EXAMINATION DATA
 Name
•
Programme
 Age/sex
•
Strategy
•
Stage/ Phase
•
Test target/ duration
( Goldmann size III )
•
Background illumination
( 31.5 apostilb )
 Eye
 Pupil size

V/A with refractive status

5. RELIABILITY
• Fixation loss
• False positive
• False negative
• Test duration
• Question / repetition

6. FALSE
POSITIVES
FALSE
NEGATIVES

7. PITFALLS
Performing perimetry
Data entry
Pupil size
Refractive error
Recognising artefacts
Fatigue effect
Reliability
Co existing ocular morbidity
Learning curve

8. GREY SCALE

9. PATIENT’S RETINAL
SENSITIVITY
NORMAL RETINAL
SENSITIVITY
DIFFERENCE
HUMPHREY
OCTOPUS
TOTAL DEVIATION NUMERICAL PLOT
COMPARISON

10. PROBABILITY PLOT

11. ELIMINATING GENERALISED
DEPRESSION

12. ELIMINATING GENERALISED
DEPRESSION
OCTOPUS
CORRECTED COMPARISONS
HUMPHREY
PATTERN DEVIATION NUMERICAL PLOT

13. BEBIE CURVE
CO values
Ranking

14. GLAUCOMA HEMIFIELD
TEST
RESULTS
Outside normal limits p <1%
Borderline p <3%
Generalized reduction of sensitivity
Abnormally high sensitivity
Within normal limits

15. ANDERSON’S CRITERIA
3
GHT – outside normal limits
2
CPSD 4 dB P <5%
1

16. ANDERSON’S CRITERIA

17. GLOBAL OR STATISTICAL
INDICES
HUMPHREY
MD
PSD
SF
CPSD
OCTOPUS
MD
LV
RMS
CLV

18. GLOBAL INDICES - MD
A
B

19. GLOBAL INDICES - MD
-2 (<-6dB) MILD GENERALISED
DEPRESSION
-7 (<-12dB) MODERATE GENERALISED
DEPRESSION
-13 (>-12dB) SEVERE GENERALISED
DEPRESSION
MD
-2.18 dB

20. GLOBAL INDICES – PSD OR LV
MEAN
150
STANDARD
DEVIATION
150
0
160
140
150
10
170
110
150
40

21. GLOBAL INDICES – PSD OR LV
PSD
4.63dB p < 1%

22. GLOBAL INDICES
HEIGHT
(MEAN
DEVIATION)
MD: NORMAL
PSD: NORMAL
MD:
ABNORMAL
PSD: NORMAL
SHAPE
(PATTERN STD
DEVIATION)
MD: NORMAL
PSD:
ABNORMAL
MD:
ABNORMAL
PSD:
ABNORMAL

23. SHORT TERM
FLUCTUATION
PATTERN STANDARD
DEVIATION
CORRECTED PATTERN
STANDARD DEVIATION
SF IN A RELIABLE FIELD: 1 –
2.5 dB

24. FIELD DEFECTS IN GLAUCOMA
 Generalised loss- Early and non-specific
 Localised loss- More specific
 Advanced field loss

25. THANK YOU

29. RAW DATA OR VALUES

30. RIM ARTEFACTS

31. SIZE OF THE PUPIL
2.2 mm
5.0 mm

32. DEVIATION OR COMPARISON
PLOTS
& PROBABILITY

33. 30
30 32
29 31 33
30 31 33
31 32
31
5
+
7
+
+
+
9
+
+
+
5
+
+
+
7
+
+
+
5
5
+
+
+
+
+
+
+
+
+
+
5
+
+
+
+
+
+
+
+
+
+
+
+
+
+
5
+
+
29
31
33
33
33
33
32
31
29
31
33
34
34
33
32
31
21
+
+ 23 28
24 27 29
+
27 27 30
+
27 27
28
29
31
32
34
34
33
32
31
28
27
26
30
32
31
27
26
29
30
32
33
33
33
32
32
27
29
30
31
33
32
29
29
31
31 31
00 32
00 32
32 32
32
28
29
28
32
32
30
30
28
29
26
28
29
32
31
28
29
27
26
00
00
30
29
28
30
30
30

34. Global Indices
• All the information
from all the points
tested is reduced to
single numbers

36. Global Indices : Mean Deviation or Mean
Defect (MD )
• Mean of deviation of the
visual field from
normal.
MD
-2.18dB

37. Global Indices Pattern Standard
Deviation (PSD) / Loss Variance (LV)
•
Standard deviation of
deviation
•
Indicates the degree to
which the numbers
differ from each other
•
“Roughness” or
“potholes” in the hill of
vision
PSD
4.63dB p < 1%

38. Sequential single field
analysis’
Printed Data
a. Name
b. Test
c. DOB
d. Parameters (check for standard size III)
e. Visual Acuity
f. Refraction
g. Pupil Diameter (>3mm)

39. Sequential single field analysis
Reliability factors
a. Fixation loss (< 20%)
b. False positive (<33%)
c. False negative (<33%)
d. Foveal Threshold (acuity & MD)
Gray scale
a. Overall Depression
b. Specific loci of defects

40. Sequential single field analysis
Total Deviation plots
a. Numeric Plot (scan briefly the numbers)
b. Probability map (clustering of high p-value)
Pattern deviation Plots
a. Numeric plot (ignore)
b. Probability map (compare to Total Deviation
map)

41. Sequential single field analysis
Numeric Data display
Investigate suspicious area in total deviation map
Review raw data in a geographic sequence
Perifoveal values
Arcuate regions
Around blind spot
Nasal step
Vertical and Horizontal axes
Peripheral areas

42. Sequential single field analysis
Global Indices
MD (cf acuity and foveal threshold)
PSD (localised defect
)
Glaucoma Hemifield Test

43. Glaucoma Hemifield Test
 5 sectors in upper field are compared to 5 mirror
images in the lower
 Nerve fibre layer defect occurs assymetrically
between hemifield

44. 4
3
2
1
5

45. Glaucoma Hemifield Test
 Outside normal limits p <1%
 Borderline p <3%
 Generalized reduction of sensitivity
 Abnormally high sensitivity
 Within normal limits