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![Visual Pathway Anatomy
• [Diagram placeholder]
• Retina → Optic nerve → Chiasm → Tract → LGN → Radiations → Cortex](https://image.slidesharecdn.com/visualfieldexamwithimages-250815002726-ef77e9f4/75/visual_field_exam_with_images-pptx-SIMPLE-4-2048.jpg)
visual_field_exam_with_images.pptx SIMPLE
- 1. Visual Field Examination Purpose• Techniques • Interpretation • Clinical Correlation
- 2. Learning Objectives • Definevisual field and list indications for testing • Describe bedside and formal methods • Explain test performance and pitfalls • Interpret common defects and localize lesions
- 3. Definition & Rationale •Assessment of full area seen while fixating straight ahead • Detects unreported visual field defects • Localizes lesions along visual pathway • Monitors progression of ocular/neurological diseases
- 4. Visual Pathway Anatomy •[Diagram placeholder] • Retina → Optic nerve → Chiasm → Tract → LGN → Radiations → Cortex
- 5. Normal Visual FieldExtents • Temporal: ~90–100° • Nasal: ~50–60° • Superior: ~50–60° • Inferior: ~70–75°
- 6. Testing Methods Overview •Confrontation test (bedside screen) • Amsler grid (central vision) • Automated perimetry (Humphrey, Octopus) • Goldmann kinetic perimetry
- 7. Confrontation Test • Seatat 1 m, occlude one eye each • Patient fixates on examiner's nose • Bring target from periphery to center • Compare with examiner's field
- 8. Amsler Grid • Monoculartesting at 30 cm with near correction • Fixate center dot • Report distortions, missing, or blurred areas
- 9. Automated Static Perimetry •Stationary light stimuli of varying intensity • Common programs: 24-2, 30-2, 10-2 • Outputs: grayscale, deviation plots, indices
- 10. Perimetry Reliability Indices •Fixation losses • False positives • False negatives • Test duration and learning effect
- 11. Interpreting Humphrey Printout •Grayscale: visual impression • Total deviation vs pattern deviation • Probability plots: statistical abnormality • Global indices: MD, PSD, VFI
- 12. Goldmann Kinetic Perimetry •Manual kinetic mapping • Useful for peripheral fields, children, neuro cases • Documents isopters for comparison
- 13. Common Defect Patterns •Monocular defect: retina/optic nerve • Bitemporal hemianopia: chiasm • Homonymous hemianopia: post-chiasm • Quadrantanopia: optic radiations • Central scotoma: macula/optic nerve
- 14. Clinical Examples • Pituitarymacroadenoma → bitemporal hemianopia • Glaucoma → arcuate scotoma, nasal step • PCA stroke → homonymous hemianopia
- 15. Reporting Template • Examtype & strategy • Reliability indices • Findings description • Impression & plan
- 16. Tips for QualityTesting • Correct refraction for near • Explain test & practice run • Test when patient is alert • Repeat baseline to reduce learning effect
- 17. Pitfalls & Limitations •Confrontation misses subtle defects • Automated perimetry needs cooperation • Media opacities cause diffuse depression • Inter-test variability
- 18. When to OrderFormal Perimetry • Abnormal confrontation • Glaucoma suspect/monitoring • Optic neuropathy • Neurological signs of visual pathway lesion
- 19. Key Takeaways • Essentialfor detecting/localizing visual pathway disease • Choose method based on clinical need • Interpret with anatomy & reliability in mind • Correlate with other findings
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Editor's Notes
- #2 State objectives clearly so audience knows what they'll learn.
- #3 Explain that defects often precede symptoms and testing is essential.
- #4 Insert labeled diagram here showing decussation and pathways.
- #5 Note variations; automated tests cover central 24–30°.
- #6 State when each is preferred; formal tests for diagnosis and monitoring.
- #7 Low sensitivity for subtle defects; still useful for quick screening.
- #8 Use for macular disease detection and monitoring.
- #9 Gold standard for glaucoma and many neuro-ophthalmic conditions.
- #10 Indices help judge validity; high fixation loss or FP = unreliable.
- #11 Show annotated printout to guide reading.
- #12 Operator-dependent but versatile.
- #13 Correlate defect patterns with lesion location.
- #14 Show visual field plots for each case.
- #15 Use consistent structured reporting for clarity.
- #16 These steps improve reliability and reproducibility.
- #17 Always correlate with history and other tests.
- #18 Indications for formal testing.
- #19 Summarize main learning points.