Perimetry tests light-difference sensitivity across the visual field. This sensitivity reflects the eye's ability to perceive brightness differences between a target and its background. Light-difference sensitivity depends on the location tested on the retina as well as test parameters like background luminance and target size.
The document discusses automated perimetry, which quantifies sensitivity across the visual field. It describes key terminology like isopters, scotomas, and luminance. Different testing strategies are outlined, including threshold perimetry using SITA. Printout zones are explained, such as raw data, reliability indices, and global indices like mean deviation. Common defects are described. Visual field progression is monitored using GPA event and trend analysis.
The document discusses principles of perimetry, which is the measurement of visual functions across the visual field. It describes the history of automated perimeters beginning in 1970. Static perimetry uses computerized testing to determine contrast sensitivity thresholds at preset locations, while kinetic perimetry manually maps sensitivity points along meridians. Both methods are used to identify decreases in retinal sensitivity indicative of conditions like glaucoma. Automated static perimetry provides quantifiable and reproducible data but is time-consuming, while kinetic perimetry rapidly defines field contours but requires more operator skill.
The Octopus 600 combines the Pulsar method and standard white-on-white perimetry for long-term follow-up in a single device.
Pulsar is a patented flicker stimulus, displaying a ring pattern with different contrast levels in counterphase. The test is easy to take, and is both sensitive and specific in the detection of early glaucoma. The Octopus 600 boasts a compact design and streamlined operation with touchscreen optimised EyeSuite software.
This document discusses automated perimetry and the interpretation of visual field tests. It covers perimeter logic and identifying field defects, criteria for glaucomatous defects, and detecting glaucomatous progression. Key points include interpreting visual fields systematically using total and pattern deviation plots in 8 zones, criteria for identifying glaucomatous defects including abnormalities in the pattern deviation plot, global indices, and techniques for detecting progression such as the overview program and Glaucoma Progression Analysis. Interpretation requires correlating results with clinical findings and considering factors like learning effects and fluctuation.
JNTERPRETATION OF SINGLE FIELD PRINTOUT FROM HUMPHREY'SDR RITA DASH
Verify patient data and test details to ensure reliability
Analyze total deviation and pattern deviation plots to identify localized scotomas, accounting for overall depression
Interpret mean deviation (MD) and pattern standard deviation (PSD) to assess hill of vision and irregularities
Use Glaucoma Hemifield Test (GHT) analysis and Anderson's criteria to diagnose glaucomatous visual field defects if disc features match
Consider lens rim artifacts, media opacities, refractive errors, pupil size, and other ocular causes when interpreting results
Automated perimetry is an important diagnostic test used to map the visual field and detect progression of diseases like glaucoma. There are two main types - kinetic perimetry where a stimulus is moved and static perimetry where stimulus intensity is varied at fixed points. Static perimetry provides a more accurate 3D representation of the visual field. Different testing strategies like full threshold, threshold, and suprathreshold are used to detect visual field defects. Automated perimetry generates various indices to analyze results and detect progression of defects over time through comparison to baseline tests. Care must be taken to avoid sources of error and false indications of change.
This document discusses visual field testing and perimetry. It defines visual field as the area that can be seen around a central point of fixation. Perimetry involves systematically measuring light sensitivity across the visual field using techniques like kinetic and static perimetry. Common perimetry devices include Humphrey, Octopus, and Goldmann perimeter. The document outlines stimulus parameters, test strategies, interpretation of results, and alternative perimetry techniques targeting different retinal pathways.
The document discusses automated perimetry, which quantifies sensitivity across the visual field. It describes key terminology like isopters, scotomas, and luminance. Different testing strategies are outlined, including threshold perimetry using SITA. Printout zones are explained, such as raw data, reliability indices, and global indices like mean deviation. Common defects are described. Visual field progression is monitored using GPA event and trend analysis.
The document discusses principles of perimetry, which is the measurement of visual functions across the visual field. It describes the history of automated perimeters beginning in 1970. Static perimetry uses computerized testing to determine contrast sensitivity thresholds at preset locations, while kinetic perimetry manually maps sensitivity points along meridians. Both methods are used to identify decreases in retinal sensitivity indicative of conditions like glaucoma. Automated static perimetry provides quantifiable and reproducible data but is time-consuming, while kinetic perimetry rapidly defines field contours but requires more operator skill.
The Octopus 600 combines the Pulsar method and standard white-on-white perimetry for long-term follow-up in a single device.
Pulsar is a patented flicker stimulus, displaying a ring pattern with different contrast levels in counterphase. The test is easy to take, and is both sensitive and specific in the detection of early glaucoma. The Octopus 600 boasts a compact design and streamlined operation with touchscreen optimised EyeSuite software.
This document discusses automated perimetry and the interpretation of visual field tests. It covers perimeter logic and identifying field defects, criteria for glaucomatous defects, and detecting glaucomatous progression. Key points include interpreting visual fields systematically using total and pattern deviation plots in 8 zones, criteria for identifying glaucomatous defects including abnormalities in the pattern deviation plot, global indices, and techniques for detecting progression such as the overview program and Glaucoma Progression Analysis. Interpretation requires correlating results with clinical findings and considering factors like learning effects and fluctuation.
JNTERPRETATION OF SINGLE FIELD PRINTOUT FROM HUMPHREY'SDR RITA DASH
Verify patient data and test details to ensure reliability
Analyze total deviation and pattern deviation plots to identify localized scotomas, accounting for overall depression
Interpret mean deviation (MD) and pattern standard deviation (PSD) to assess hill of vision and irregularities
Use Glaucoma Hemifield Test (GHT) analysis and Anderson's criteria to diagnose glaucomatous visual field defects if disc features match
Consider lens rim artifacts, media opacities, refractive errors, pupil size, and other ocular causes when interpreting results
Automated perimetry is an important diagnostic test used to map the visual field and detect progression of diseases like glaucoma. There are two main types - kinetic perimetry where a stimulus is moved and static perimetry where stimulus intensity is varied at fixed points. Static perimetry provides a more accurate 3D representation of the visual field. Different testing strategies like full threshold, threshold, and suprathreshold are used to detect visual field defects. Automated perimetry generates various indices to analyze results and detect progression of defects over time through comparison to baseline tests. Care must be taken to avoid sources of error and false indications of change.
This document discusses visual field testing and perimetry. It defines visual field as the area that can be seen around a central point of fixation. Perimetry involves systematically measuring light sensitivity across the visual field using techniques like kinetic and static perimetry. Common perimetry devices include Humphrey, Octopus, and Goldmann perimeter. The document outlines stimulus parameters, test strategies, interpretation of results, and alternative perimetry techniques targeting different retinal pathways.
This document discusses visual field assessment using static perimetry. It describes situations where visual field testing is recommended, such as for glaucoma diagnosis. It explains that the central 30 degrees of vision represents the majority of ganglion cells and visual cortex. The document reviews how to interpret visual field test results, including checking for reliability, identifying patterns of defects, and comparing results to age-matched normal data. It provides examples of normal and glaucomatous visual field defects. Key visual field indices are also described, such as mean sensitivity and mean defect, which provide an overall assessment of the visual field.
Visual field testing is an important diagnostic consideration in the evaluation of patients with many different types of pathologies. Most commonly, it is used for conditions affecting the optic nerve and other forms of neurological disease; but it’s also helpful for retinal conditions and instances when visual field function needs to be measured.
At the end of the lecture optometrists will have a better understanding of testing and interpreting visual field results.
Interpretation of visual fields with special reference to octopusHaitham Al Mahrouqi
The document provides an overview of visual field interpretation using the Octopus perimeter. It discusses what a visual field is, why they are important, and types of perimetry including static and kinetic. It describes advantages of different test strategies like TOP and SITA fast that can reduce test time. Key aspects of the Octopus 7-in-1 printout are outlined including demographic data, reliability indices, threshold values compared to norms, and mean deviation and pattern deviation plots.
The document summarizes the key information provided in a Humphrey Field Analyzer printout. It describes the patient data, reliability indicators, raw numeric thresholds, grey scale and total deviation plots which show sensitivity values compared to age-corrected normals, and the pattern deviation plot which shows sensitivity loss after adjusting for generalized depression. It also defines the mean deviation and pattern standard deviation metrics, noting that more negative MD values and more positive PSD values indicate a worsening visual field.
This document discusses the visual field and visual field testing. It defines the visual field as the part of the environment that can be detected by a steady eye. It then discusses the physiological basis of the visual field and factors that can affect visual field testing results, such as stimulus characteristics and patient factors. The document also summarizes different types of visual field defects and explains common perimetry techniques and their advantages. It provides details on visual field test interpretation, including reliability indices, total and pattern deviation plots, and classification of results.
This document provides an overview of Humphrey visual field (HVF) testing. HVF uses static perimetry to measure threshold sensitivity values across the visual field and compare them to normative data. It uses white stimuli on a white background presented for 0.2 seconds. Common testing programs include 30-2, 24-2, and 10-2 patterns. The results are analyzed using global indices, total and pattern deviation plots, and the Glaucoma Hemifield Test. Test quality must be ensured through reliability indices and proper patient preparation. Visual field defects are evaluated based on probability plots and Anderson's criteria to determine if they are outside normal limits. Progression is monitored by frequent testing, especially if mean deviation is changing
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.
Perimetry is a test that measures the visual field and is important for diagnosing and managing glaucoma. There are two main types of perimetry - kinetic and static. The Humphrey visual field test is a type of static, automated perimetry that uses thresholds to test the central and peripheral visual field. It provides reliable indices and plots like total deviation and pattern deviation to analyze visual field defects and monitor for progression of glaucoma. Common visual field defects seen in glaucoma include localized defects, arcuate scotomas, nasal steps, and advanced defects like tunnel vision.
The document describes the Amsler grid chart, which was developed in 1920 by Dr. Marc Amsler to test for central vision disorders. It consists of a grid pattern with white lines on a black background that is used to evaluate the macula. Patients are asked a series of questions while viewing the chart to check for blurriness, distortions, or missing areas that could indicate conditions like macular degeneration or retinal detachment. The document outlines the purposes and procedures for several variations of the Amsler grid and provides instructions for patients to perform self-examinations at home in order to monitor eye conditions.
The document provides instructions for acquiring OCT scans using the Cirrus HD-OCT system. It describes the hardware components integrated into the Cirrus unit and identifies each part. It then explains the steps for adding a new patient, selecting the desired scan type, preparing the patient, and acquiring the scan. This involves using the iris viewport to center the pupil, focusing the fundus viewport, optimizing the scan placement over the area of interest, and capturing the scan image. Adjustments can be made to the brightness, contrast and focus during alignment.
This document discusses visual field testing methods and interpretation. It describes common visual field tests including confrontation, kinetic perimetry, and static automated perimetry. Normal visual fields subtend approximately 140 degrees monocularly. Automated static perimetry tests like Humphrey and Octopus are now commonly used to evaluate for conditions like glaucoma by testing the central 24 or 30 degrees. Test results are interpreted through gray scale and total deviation plots to identify localized areas of visual field loss and global indices provide an overall measure of sensitivity. Common defects seen in glaucoma include arcuate scotomas and temporal wedges. Neurological field defects can be homonymous or heteronomous depending on the lesion location.
This document discusses automated perimetry, which is an important diagnostic test for mapping the visual field in an automated way to diagnose and monitor diseases like glaucoma. It describes the basics of perimetry testing including light intensity measurements, stimulus size, threshold testing, and different testing methods. It then explains how to interpret perimetry results by analyzing zones like reliability indices, total and pattern deviation plots, global indices, and other metrics to determine if defects are present and compatible with a condition like glaucoma.
The document discusses visual field testing in glaucoma. It defines the visual field and perimetry, and describes the major types of clinical perimetry tests including full threshold, SITA standard, and SITA fast on Humphrey and normal, dynamic, and TOP strategies on Octopus. It explains parameters such as test patterns, reliability, age-corrected plots, tests like GHT and Bebie curve, and global indices including MD, PSD, SF, and CPSD. The purpose of visual field testing in glaucoma is to detect and monitor disease by measuring light sensitivity across the retinal field.
How to interpret the visual field printout
Learn basic terms of visual field analysis
How to diagnose glaucomatous field defect
How to diagnose neurological field defect
Perimetry is a test that measures light sensitivity across the visual field. There are several types of perimetry tests, including kinetic, static threshold, and static suprathreshold. Kinetic perimetry involves a moving stimulus and can quickly detect peripheral defects, while static perimetry uses fixed targets to precisely measure light sensitivity thresholds at specific locations. Interpretation of perimetry results involves analyzing reliability, identifying any visual field defects, and determining their potential causes. The Humphrey perimeter is commonly used, allowing automated static threshold testing through programs like 30-2 that test the central visual field.
This document summarizes a study comparing the ability of seven contact lens designs to reduce higher-order aberrations (HOA) in 16 eyes. An aberrometer was used to measure HOA both without lenses and with each lens design. The study found that Definition HD contact lenses reduced HOA in 14 out of 16 eyes, more than all other lens designs tested, lowering HOA over four times more than the next best competitor. Definition lenses also lowered spherical aberration in 11 out of 16 eyes, more than other lenses, offering a better option for aberration control compared to first generation aspheric lenses.
This document discusses visual field testing techniques used to evaluate the peripheral visual field. It describes common manual and automated methods, including confrontation, kinetic perimetry, and static threshold testing. The document provides details on visual field devices such as the Goldmann perimeter, Humphrey Field Analyzer, and Frequency Doubling Technology perimeters. It also reviews data analysis, common defects, and the use of visual field testing to evaluate conditions like glaucoma, neurologic diseases, and side effects of medications.
The document defines the visual field and describes methods for examining it, including confrontation testing, tangent screen testing, Amsler grid testing, static and kinetic perimetry, and Humphrey Field Analyzer (HFA) testing. It discusses the normal limits of the visual field and reliability indices used to evaluate HFA test results, such as fixation losses, false positives, and false negatives. Single field analysis results from the HFA including sensitivity values, gray scale maps, and total and pattern deviation plots are also summarized.
Visual field testing and interpretationRaman Gupta
This document provides an overview of visual field testing and interpretation. It begins with definitions of key visual field terminology. It then discusses the history of visual field testing and describes common testing methods like kinetic and static perimetry. Goldmann perimetry and automated perimetry are explained in detail. The document reviews how to interpret visual field results, including expected normal limits and descriptions of common visual field defects. It provides guidelines for visual field testing and plotting isopters. Overall, the document serves as a comprehensive guide to visual field assessment.
This document provides an overview of visual field examination and interpretation of automated perimetry results. It discusses the different types of perimetry testing including kinetic, static, and automated threshold testing. Important testing parameters like reliability indices, total deviation plots, and glaucoma hemifield tests are explained. Common visual field defects seen in conditions like glaucoma are demonstrated. The summary emphasizes that visual field defects must be reproducible to confirm abnormalities and clinical correlation is important when interpreting results.
This document discusses visual field assessment using static perimetry. It describes situations where visual field testing is recommended, such as for glaucoma diagnosis. It explains that the central 30 degrees of vision represents the majority of ganglion cells and visual cortex. The document reviews how to interpret visual field test results, including checking for reliability, identifying patterns of defects, and comparing results to age-matched normal data. It provides examples of normal and glaucomatous visual field defects. Key visual field indices are also described, such as mean sensitivity and mean defect, which provide an overall assessment of the visual field.
Visual field testing is an important diagnostic consideration in the evaluation of patients with many different types of pathologies. Most commonly, it is used for conditions affecting the optic nerve and other forms of neurological disease; but it’s also helpful for retinal conditions and instances when visual field function needs to be measured.
At the end of the lecture optometrists will have a better understanding of testing and interpreting visual field results.
Interpretation of visual fields with special reference to octopusHaitham Al Mahrouqi
The document provides an overview of visual field interpretation using the Octopus perimeter. It discusses what a visual field is, why they are important, and types of perimetry including static and kinetic. It describes advantages of different test strategies like TOP and SITA fast that can reduce test time. Key aspects of the Octopus 7-in-1 printout are outlined including demographic data, reliability indices, threshold values compared to norms, and mean deviation and pattern deviation plots.
The document summarizes the key information provided in a Humphrey Field Analyzer printout. It describes the patient data, reliability indicators, raw numeric thresholds, grey scale and total deviation plots which show sensitivity values compared to age-corrected normals, and the pattern deviation plot which shows sensitivity loss after adjusting for generalized depression. It also defines the mean deviation and pattern standard deviation metrics, noting that more negative MD values and more positive PSD values indicate a worsening visual field.
This document discusses the visual field and visual field testing. It defines the visual field as the part of the environment that can be detected by a steady eye. It then discusses the physiological basis of the visual field and factors that can affect visual field testing results, such as stimulus characteristics and patient factors. The document also summarizes different types of visual field defects and explains common perimetry techniques and their advantages. It provides details on visual field test interpretation, including reliability indices, total and pattern deviation plots, and classification of results.
This document provides an overview of Humphrey visual field (HVF) testing. HVF uses static perimetry to measure threshold sensitivity values across the visual field and compare them to normative data. It uses white stimuli on a white background presented for 0.2 seconds. Common testing programs include 30-2, 24-2, and 10-2 patterns. The results are analyzed using global indices, total and pattern deviation plots, and the Glaucoma Hemifield Test. Test quality must be ensured through reliability indices and proper patient preparation. Visual field defects are evaluated based on probability plots and Anderson's criteria to determine if they are outside normal limits. Progression is monitored by frequent testing, especially if mean deviation is changing
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.
Perimetry is a test that measures the visual field and is important for diagnosing and managing glaucoma. There are two main types of perimetry - kinetic and static. The Humphrey visual field test is a type of static, automated perimetry that uses thresholds to test the central and peripheral visual field. It provides reliable indices and plots like total deviation and pattern deviation to analyze visual field defects and monitor for progression of glaucoma. Common visual field defects seen in glaucoma include localized defects, arcuate scotomas, nasal steps, and advanced defects like tunnel vision.
The document describes the Amsler grid chart, which was developed in 1920 by Dr. Marc Amsler to test for central vision disorders. It consists of a grid pattern with white lines on a black background that is used to evaluate the macula. Patients are asked a series of questions while viewing the chart to check for blurriness, distortions, or missing areas that could indicate conditions like macular degeneration or retinal detachment. The document outlines the purposes and procedures for several variations of the Amsler grid and provides instructions for patients to perform self-examinations at home in order to monitor eye conditions.
The document provides instructions for acquiring OCT scans using the Cirrus HD-OCT system. It describes the hardware components integrated into the Cirrus unit and identifies each part. It then explains the steps for adding a new patient, selecting the desired scan type, preparing the patient, and acquiring the scan. This involves using the iris viewport to center the pupil, focusing the fundus viewport, optimizing the scan placement over the area of interest, and capturing the scan image. Adjustments can be made to the brightness, contrast and focus during alignment.
This document discusses visual field testing methods and interpretation. It describes common visual field tests including confrontation, kinetic perimetry, and static automated perimetry. Normal visual fields subtend approximately 140 degrees monocularly. Automated static perimetry tests like Humphrey and Octopus are now commonly used to evaluate for conditions like glaucoma by testing the central 24 or 30 degrees. Test results are interpreted through gray scale and total deviation plots to identify localized areas of visual field loss and global indices provide an overall measure of sensitivity. Common defects seen in glaucoma include arcuate scotomas and temporal wedges. Neurological field defects can be homonymous or heteronomous depending on the lesion location.
This document discusses automated perimetry, which is an important diagnostic test for mapping the visual field in an automated way to diagnose and monitor diseases like glaucoma. It describes the basics of perimetry testing including light intensity measurements, stimulus size, threshold testing, and different testing methods. It then explains how to interpret perimetry results by analyzing zones like reliability indices, total and pattern deviation plots, global indices, and other metrics to determine if defects are present and compatible with a condition like glaucoma.
The document discusses visual field testing in glaucoma. It defines the visual field and perimetry, and describes the major types of clinical perimetry tests including full threshold, SITA standard, and SITA fast on Humphrey and normal, dynamic, and TOP strategies on Octopus. It explains parameters such as test patterns, reliability, age-corrected plots, tests like GHT and Bebie curve, and global indices including MD, PSD, SF, and CPSD. The purpose of visual field testing in glaucoma is to detect and monitor disease by measuring light sensitivity across the retinal field.
How to interpret the visual field printout
Learn basic terms of visual field analysis
How to diagnose glaucomatous field defect
How to diagnose neurological field defect
Perimetry is a test that measures light sensitivity across the visual field. There are several types of perimetry tests, including kinetic, static threshold, and static suprathreshold. Kinetic perimetry involves a moving stimulus and can quickly detect peripheral defects, while static perimetry uses fixed targets to precisely measure light sensitivity thresholds at specific locations. Interpretation of perimetry results involves analyzing reliability, identifying any visual field defects, and determining their potential causes. The Humphrey perimeter is commonly used, allowing automated static threshold testing through programs like 30-2 that test the central visual field.
This document summarizes a study comparing the ability of seven contact lens designs to reduce higher-order aberrations (HOA) in 16 eyes. An aberrometer was used to measure HOA both without lenses and with each lens design. The study found that Definition HD contact lenses reduced HOA in 14 out of 16 eyes, more than all other lens designs tested, lowering HOA over four times more than the next best competitor. Definition lenses also lowered spherical aberration in 11 out of 16 eyes, more than other lenses, offering a better option for aberration control compared to first generation aspheric lenses.
This document discusses visual field testing techniques used to evaluate the peripheral visual field. It describes common manual and automated methods, including confrontation, kinetic perimetry, and static threshold testing. The document provides details on visual field devices such as the Goldmann perimeter, Humphrey Field Analyzer, and Frequency Doubling Technology perimeters. It also reviews data analysis, common defects, and the use of visual field testing to evaluate conditions like glaucoma, neurologic diseases, and side effects of medications.
The document defines the visual field and describes methods for examining it, including confrontation testing, tangent screen testing, Amsler grid testing, static and kinetic perimetry, and Humphrey Field Analyzer (HFA) testing. It discusses the normal limits of the visual field and reliability indices used to evaluate HFA test results, such as fixation losses, false positives, and false negatives. Single field analysis results from the HFA including sensitivity values, gray scale maps, and total and pattern deviation plots are also summarized.
Visual field testing and interpretationRaman Gupta
This document provides an overview of visual field testing and interpretation. It begins with definitions of key visual field terminology. It then discusses the history of visual field testing and describes common testing methods like kinetic and static perimetry. Goldmann perimetry and automated perimetry are explained in detail. The document reviews how to interpret visual field results, including expected normal limits and descriptions of common visual field defects. It provides guidelines for visual field testing and plotting isopters. Overall, the document serves as a comprehensive guide to visual field assessment.
This document provides an overview of visual field examination and interpretation of automated perimetry results. It discusses the different types of perimetry testing including kinetic, static, and automated threshold testing. Important testing parameters like reliability indices, total deviation plots, and glaucoma hemifield tests are explained. Common visual field defects seen in conditions like glaucoma are demonstrated. The summary emphasizes that visual field defects must be reproducible to confirm abnormalities and clinical correlation is important when interpreting results.
To know Humphrey visual field analyser
To know about various types of perimetry
To identify field defect
To recognize that field defect is due to glaucoma or neurological lesion
To know that field defect is progressive or not
Interpretation of HVFA
The document discusses the field of vision, including its anatomy and testing methods. It notes that the field of vision is like an island surrounded by blindness, with the fovea being the summit of highest sensitivity and the blind spot being the trough of zero sensitivity. It describes kinetic and static perimetry testing methods and different types of visual field defects seen in conditions like glaucoma and neurological disorders. Global indices, reliability indices, and corrected pattern deviation maps are used to analyze perimetry results. Factors affecting testing and new techniques like FDT perimetry are also mentioned.
1. The document provides instructions for interpreting a Humphry Visual Field (HVF) report, including confirming patient details, testing parameters, reliability indices, and analyzing results like mean deviation and pattern deviation to identify possible visual field defects indicative of glaucoma. Key pieces of information to examine include pupil size, fixation losses, reliability, grayscale results, mean deviation, pattern deviation, and Glaucoma Hemifield Test results. An MD of -2.00 or less could indicate the presence of glaucoma.
This document summarizes a seminar on assessing the visual field using automated perimetry. It defines key terminology used in visual field testing like threshold, apostilbs, decibels, and indices. It describes the components and functioning of the Humphrey Field Analyzer automated perimeter. It provides criteria for diagnosing glaucoma based on visual field tests and categorizes the severity of visual field defects as early, moderate, or severe. It also outlines how to recognize progressive damage by comparing tests over time.
Kinetic perimetry involves moving a test object across the visual field while the patient fixates, allowing mapping of the field boundaries. Goldman perimetry is a common kinetic technique where different sized targets are used to map isopters representing lines of equal sensitivity. Proper patient preparation, choice of targets, and systematic mapping strategies are required. Interpretation of the results considers potential artifacts and examines features like location and shape of any defects to derive a clinical impression. Other kinetic techniques include tangent screen and Bernell disc perimetry.
This document defines perimetry and discusses the objectives, normal visual field parameters, common terms, and types of perimetry. It also describes automated static perimetry testing protocols, algorithms, stimulus intensity, and interpretations of visual field printouts including reliability indices, total deviation plots, and glaucoma hemifield tests. Factors that can cause errors in perimetry testing are also outlined.
This document discusses visual field testing and perimetry. It defines the visual field and describes common visual field defects. It then covers the indications, methods, and terminology of visual field testing. Specific details are provided on threshold testing strategies, reliability indices, and how to interpret visual field printout maps and global indices. Criteria for diagnosing glaucomatous visual field loss and detecting progression over time are also outlined.
This document provides an overview of perimetry testing and the anatomy of the eye. It discusses the historical methods of perimetry including the Amsler grid, confrontation test, and tangent screen. It then covers the Goldmann perimeter, which set the standard for glaucoma diagnosis. The document also reviews the structures of the eye such as the retina, macula, optic nerve, and rods and cones. It explains how pathologies in different areas like the optic chiasm can affect one or both eyes. The overall goal is to understand the principles and history of visual field testing.
Low vision patient have serious visual problems that have caused serious visual loss.
1. Contrast sensitivity testing and visual field testing
2. subjective testing of patients with media loss
# potential acuity meter
# interferometry
# photostress recovery test
# glare test
# color vision test
# dark adaptometry
3. objective testing of retinal loss
# USG
ERG/EOG
There are several new developments in perimetry that test different subsets of retinal ganglion cells. Short wavelength perimetry assesses blue-yellow color opponent pathways mediated by K cells. Frequency doubling perimetry and motion perimetry primarily test M cells. High pass resolution perimetry and acuity perimetry mainly assess P cells. These targeted perimetry techniques may detect glaucomatous damage earlier than standard perimetry and provide a more detailed assessment of visual function.
A Systematic Comparison of Spectral-Domain Optical Coherence Tomography and F...John Redaelli
This study compared spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) for grading geographic atrophy (GA) in age-related macular degeneration. Two graders manually measured GA lesion size using SD-OCT and FAF in 81 eyes. SD-OCT measurements of choroidal signal enhancement and loss of outer retinal layers correlated closely with areas of decreased FAF. SD-OCT also more accurately identified foveal involvement than FAF. The study demonstrates SD-OCT can reliably quantify GA lesion size and progression in a reproducible manner.
This document discusses perimetry and visual field testing. It begins by introducing the presenters and moderator of the discussion on perimetry. It then defines visual field and normal visual field limits. Perimetry is defined as the study of the visual field using an instrument called a perimeter. The document outlines the history of computerized perimetry and reasons for its use. Visual field testing is used to diagnose ocular and neurological conditions like glaucoma and brain tumors. Printouts from visual field tests are described and various visual field defects are interpreted. Factors like stimulus size, fixation, and refractive error and their effects on tests are covered. The role of visual field analysis in diagnosing neurological diseases and interpreting glaucom
This study examined the correlation between central corneal thickness (CCT) and results from Frequency Doubling Technology Perimetry (FDT) in 180 patients aged 40 or older with high intraocular pressure (IOP) but normal optic discs. The average CCT across both eyes was 531 microns. Abnormal FDT results were found in 18 subjects, who had thinner average CCT of 519 microns, compared to 532 microns in 162 subjects with normal FDT results. The study concludes that among patients with high IOP but normal discs, thicker corneas are associated with a lower risk of early glaucomatous damage detected by FDT, compared to patients with thinner corneas.
An evaluation of computer based color vision deficiency test egypt as a stu...Aboul Ella Hassanien
1) The document evaluates a computer-based color vision deficiency test compared to a paper-based Ishihara test.
2) 267 Egyptian university students and staff participated in both tests, with 21 found to have red-green color vision deficiency by both tests.
3) The computer-based test showed 100% sensitivity and 98.78% specificity compared to the paper-based test results.
The document discusses how to interpret visual field tests, specifically the Humphrey Visual Field test. It provides details on:
- The anatomy and physiology of the visual field and hill of vision.
- Types of perimetry tests including static, kinetic, threshold, and supra-threshold tests.
- Components and procedures of Humphrey Visual Field testing including stimuli, test patterns like 24-2 and 10-2, and testing types.
- What the test printout shows including reliability indices, threshold values, deviation maps, and gaze tracking records.
- What abnormalities are looked for in glaucoma, neurological diseases, and retinal diseases and how the test helps in diagnosis and monitoring of these conditions.
Learning Effect and Test-Retest Variability in Healthy Subjects and Patients ...inventionjournals
Aim: To study learning effect (LE) and test retest variability (TRV) in healthy subjects and patients with primary open angle glaucoma (POAG) using Rarebit perimetry (RBP). To determine normative ranges of RBP. Methods: 61 eyes of 35 subjects underwent visual field testing with standard automated perimetry (SAP) and RBP. TRV and LE were assessed in repeated examinations conducted in 3 different days. First two examinations were conducted within 3 days and the last one within one month. LE was assessed by comparing results from the three sessions. TRV was evaluated by calculating differences between retest for each combination of single tests. To determine normative ranges of RBP were included 34 eyes of 21 healthy subjects and 62 eyes of 47 subjects with preperimetric and early POAG. Cut off value was determined between the two groups using ROC analysis. Results: No significant LE was observed in POAG group. There was a significant LE in the control group but only in the visual field zones with eccentric location. TRV was higher in POAG group and in central visual field zone. The mean MHR in control group was 94.88 (SD 2.21) and 83.56 (SD 6.95) in POAG group. Cut off value for discriminating between healthy subjects and patient with POAG was 91.50% with AUROC 0.985 (p<0.001, ROC analysis). Conclusion: RBP is fast and easy to perform test. RBP testing did not show a significant LE in glaucoma group, however, TRV was consistent. MHR can be successfully used for differentiation of healthy eye from those with early glaucoma changes.
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TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
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2. • Perimetry normally tests the light-difference
sensitivity across the visual field.
• This sensitivity reflects the capability of the
eye to perceive a brightness difference
between a test target and its background.
• Light-difference sensitivity depends upon the
tested location on the retina and upon the
parameters of the measurement technique,
such as intensity of background luminance
and target size.
Perimetry
4/14/2020 Ehab Nafie, perimetric printout 2
8. Examination Strategies
SITA, (Swedish Interactive Threshold
Algorithm) (SITA) Standard and SITA Fast
Full Threshold
Fast Pac
Humphrey Field Analyzer
4/14/2020 Ehab Nafie, perimetric printout 8
13. An HFA 30-2 dB printout for RT eye
The tested points
are spaced in an
equidistant grid
pattern, with each
point 6 degrees
apart horizontally
or vertically from
any adjacent
point.
dB printouts
illustrate the grid
patterns.4/14/2020 Ehab Nafie, perimetric printout 13
15. Glaucoma hemifield test
The GHT, devised for the Humphrey Field Analyzer,
compares 24-2 visual fields into 10 regions, with 5
inferior regions representing mirror images of 5
corresponding superior regions.
Differences between corresponding superior and
inferior zones are compared with the differences
present in the population of normal controls.
4/14/2020 Ehab Nafie, perimetric printout 15
17. Glaucoma hemifield test
Outside normal limits. The GHT is described as
“outside normal limits” when differences between a
matched pair of corresponding zones exceeds the
difference found in 99% of the normal population, or
when both members of a pair of zones are more
abnormal than 99.5% of the individuals with the
normative population.
Borderline. The GHT is described as borderline when
matched pairs of zones are abnormal at the 97th %
within the normative database,
4/14/2020 Ehab Nafie, perimetric printout 17
18. Glaucoma hemifield test
General reduction of sensitivity. VFs are described to have
generalized reduction of sensitivity when both conditions for
“outside normal limits” are not met, and the best region of
the VF is depressed to a level at the 99.5th percentile within
individuals of the normative database.
Abnormally high sensitivity. The GHT is described as
having abnormally high sensitivity when the overall
sensitivity in the affected region of the VF is better than
99.5% of individuals within the normative population.
Within normal limits. VFs are described as being within
normal limits when none of the above conditions are met.
4/14/2020 Ehab Nafie, perimetric printout 18
19. Message
A GHT message of "outside normal
limits" on two occasions with
corresponding optic nerve or retinal
nerve fiber layer loss is very strong
evidence that glaucomatous visual
field loss is present.
4/14/2020 Ehab Nafie, perimetric printout 19
20. Patterns of Glaucomatous Visual
Field loss
Generalized depression
Paracentral scotoma
Arcuate or Bjerrum scotoma
Nasal Step
Altitudinal Defect
Temporal Wedge
Central island
VF defect must correlate with Optic nerve
damage
4/14/2020 Ehab Nafie, perimetric printout 20
21. An HFA 24-2 dB printout
RT
LT
4/14/2020 Ehab Nafie, perimetric printout 21
23. Assess reliability
Diagnostic and management
decisions should not be made on
the basis of unreliable data.
The three measures of reliability
are
1. fixation losses,
2. false negatives, and
3. false positives.
4/14/2020 Ehab Nafie, perimetric printout 23
24. Reliability tests
An examination with a false positive
rate of 15% or higher should be
considered unreliable.
It is important to recognize that it
may take two or three visual field
examinations for the patient to
produce a reliable and valid visual
field test.
4/14/2020 Ehab Nafie, perimetric printout 24
25. Reliability tests
False negatives occur when a
patient does not respond to a
stimulus that should be visible for
that patient.
Because false negatives increase
with worsening visual field loss, a
high number of false negatives in a
glaucomatous field do not necessarily
represent unreliable data.
4/14/2020 Ehab Nafie, perimetric printout 25
26. Reliability tests
False positives, on the other hand, are
always an indicator of an unreliable test.
They occur when the patient responds when
a response was not expected.
False positives make the visual field look
better (more sensitive) than it actually is
and may mask shallow depressions.
Patients with high false positives also may
have a "white" grayscale and/or abnormally
high threshold values, especially in the
peripheral parts of the field.
4/14/2020 Ehab Nafie, perimetric printout 26
27. Test Duration
A typical 24-2 threshold test
takes about 7-10 minutes.
A patient with a very disturbed
field will take longer.
4/14/2020 Ehab Nafie, perimetric printout 27
31. Glaucomatous defects
Deviation plots and their corresponding
statistical probability plots demand the
most attention.
These plots identify areas of the field that
are abnormal compared with an age-
matched normal population for each point
tested.
The information is given both in decibels
and in statistical probability values.
4/14/2020 Ehab Nafie, perimetric printout 31
32. Glaucomatous defects
In the probability plots,
increasingly dark squares represent
increasingly significant deviations
from normal.
The pattern deviation plot gives the
same type of information as the total
deviation plot, after the visual field
has been adjusted for any overall
depression or elevation.
4/14/2020 Ehab Nafie, perimetric printout 32
33. Pattern deviation plot
This plot is helpful
in patients who may
have a combined
overall depression
(from media
opacity, for
example) as well as
localized loss from
glaucoma.
4/14/2020 Ehab Nafie, perimetric printout 33
34. Global indices
The two global indices used in SITA
testing are mean deviation (MD) and
pattern standard deviation (PSD).
The MD is a measure of the average
deviation between the patient's
sensitivity and that of age-matched
normal.
4/14/2020 Ehab Nafie, perimetric printout 34
35. Global indices
MD is affected by:
Media opacities,
Uncorrected refractive error, and
Small pupils, and it may not reach
statistical significance from a small
or shallow localized glaucomatous
defect.
4/14/2020 Ehab Nafie, perimetric printout 35
36. Global indices
PSD is a measure that reflects the shape
or "smoothness" of the hill of vision and is
much more reflective of localized loss,
such as that found in glaucoma.
It is important to realize, that other
disease processes can cause localized loss
and may result in an elevated pattern
standard deviation.
4/14/2020 Ehab Nafie, perimetric printout 36
37. Message
A PSD that reaches the 5% statistical
significance level on multiple
examinations, in the presence of
other suspicious clinical findings, is
very strong evidence that a
glaucomatous visual field defect is
present.
4/14/2020 Ehab Nafie, perimetric printout 37
38. When evaluating test reliability, we have
to look at the numbers printed on the
Numeric Results (decibel [dB]) graph.
A value of 40 dB or higher on this graph
indicates that the patient may be "trigger
happy."
That is, the patient is anticipating the
presentation of the stimulus and is
responding before the stimulus is seen.
4/14/2020 Ehab Nafie, perimetric printout 38
39. Readings of 40 dB or higher indicate
an unreliable field that will need to
be repeated.
It is best to catch these readings
while the test is in progress and
restart the test.
A typical "normal" dB reading is
around 30.
4/14/2020 Ehab Nafie, perimetric printout 39
40. Refraction
The appropriate refraction
should be listed to allow
proper vision for the
testing distance of the
perimetry bowl.
Astigmatism more than
1.25 D should be corrected
in addition to the sphere
adjustments.
Special attention should be
given to aphakic and
pseudophakic patients,
regardless of age, as well
as those who wear contact
lenses.
4/14/2020 Ehab Nafie, perimetric printout 40
41. Test duration
A prolonged testing time may
indicate patient fatigue and must be
considered if there is a large
amount of global depression.
A higher rate of false positives and
negatives may occur at the edges
of scotomas due to glaucoma,
which must be accounted for when
evaluating reliability.
4/14/2020 Ehab Nafie, perimetric printout 41
45. Visual field interpretation
Look for signs of unreliable fields: Are there
many false positives (> 15% using SITA), or losses
of fixation (> 33%)?
Is there a lens rim artifact or uncorrected ptosis?
If the fields appear reliable, continue to step 2.
Look at the sensitivity map to determine whether
the field is within normal limits.
If the fields are within normal limits, there is no
further analysis.
If one or both of the eyes exhibit abnormal fields,
continue to step 3.
4/14/2020 Ehab Nafie, perimetric printout 45
46. STEP 2: Look for glaucomatous
defects
Once the field has been deemed
reliable, it should be evaluated for
glaucomatous defects.
The grayscale should not be used for
decision-making in glaucoma, but it is
helpful to draw attention to areas that
need further evaluation using number
and probability plots.
47. STEP 3: Look at the GHT and
global indices.
The GHT is based on the fact that
glaucoma damages the superior and
inferior fields asymmetrically.
The GHT compares mirror-image
clusters of points in the superior and
inferior fields, and it alerts the clinician
when significant differences are
found between the two hemifields.
48. Visual field interpretation
Is the visual field damage present in one or both
eyes?
If only one eye is affected, the damage is located
in front of the optic chiasm (i.e. the cornea,
vitreous, retina, or optic nerve of only one eye).
Damage in the visual fields of both eyes could be
due to damage at the level of the optic chiasm
and beyond, or due to separate damage in the
visual pathways of each eye anterior to the
chiasm.
4/14/2020 Ehab Nafie, perimetric printout 48
49. Visual field interpretation
Locate the region of the visual field deficit.
Refer to the patterns of visual field defects chart
to determine the likely region of damage to the
visual pathway.
Identify the shape of the visual field defect.
Refer to the chart to determine the likely region
of damage to the visual pathway.
4/14/2020 Ehab Nafie, perimetric printout 49
50. Visual field interpretation
Compare these visual fields with each of the
patient's previous visual field tests to identify
progression of visual field loss.
Do not take a shortcut by comparing these fields
to only the most recent visual field, as this may
be misleading.
Generally three or more visual field tests are
necessary to evaluate disease progression.
Consider the findings in the context of the
physical exam findings and the results of other
tests and imaging.
4/14/2020 Ehab Nafie, perimetric printout 50
51. Not every VF defect is
glaucoma
4/14/2020 Ehab Nafie, perimetric printout 51