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The Visual Field in Glaucoma

Published Online: August 5th 2012 European Ophthalmic Review, 2012;6(4):222-6 DOI: http://doi.org/10.17925/eor.2012.06.04.222
Authors: Paolo Brusini, Claudia Tosoni, Marco Zeppieri
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Abstract

Visual field (VF) testing is currently the most useful technique in both confirming diagnosis and monitoring patients during the follow-up of chronic glaucoma. Relative paracentral scotomas and nasal steps are usually the earliest signs of glaucomatous functional damage. VF damage severity can be assessed by various classification systems, like the Hodapp et al. and Advanced Glaucoma Intervention Study (AGIS) method and the Glaucoma Staging System. Progression can be analysed based on clinical judgment, defect classification systems, trend analysis and event analysis. When standard automated perimetry is within normal limits in suspect glaucoma patients, various non-conventional VF testing techniques can be useful in detecting the first signs of functional damage. These techniques include short-wavelength automated perimetry, frequency doubling technology, flicker automated perimetry and other methods that are still experimental (e.g. motion perimetry, rarebit perimetry and pulsar perimetry). It should be remembered, however, that VF testing, even if automated, is a psycho-physical test with physiological short- and long-term fluctuations, and possible artifacts.

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