Testing Visual Fields in Children

2022 ◽  
pp. 67-85
Author(s):  
Jacky K. W. Kong
Keyword(s):  
Visual Field ◽  
Pediatric Population ◽  
Visual Fields ◽  
Frequency Doubling ◽  
Field Testing ◽  
Visual Field Testing ◽  
Frequency Doubling Technology ◽  
Kinetic Perimetry ◽  
Finger Counting ◽  
Physical Abilities

Visual fields in the pediatric population are an essential part of the eye exam that remain challenging to even the most experienced clinicians. Becoming educated in the multiple ways a child's visual field can be tested regardless of age and cognitive and physical abilities will allow the clinician to gain better insight into the child's function and in some cases, allow the clinician to identify pathological or neurological anomalies in the visual pathway. Gross visual field or functional visual field extent can be estimated by tests such as confrontation visual field testing, finger counting field testing, and white sphere kinetic perimetry. For threshold measurements of a child's visual fields, the Goldmann perimeter, or the more advanced computerized tests such as the Humphrey perimeter, Octopus perimeter, or frequency doubling technology perimeter can be used. Modifications can be made to certain tests to better suit the child's cognitive and physical abilities. The chapter covers different methods of visual field testing specific for the pediatric population.

Visual Field Testing

Glaucoma ◽  
2012 ◽  
Author(s):  
Troy Close
Keyword(s):  
Visual Acuity ◽  
Visual Field ◽  
Field Testing ◽  
Spot Size ◽  
Visual Field Defects ◽  
Visual Field Testing ◽  
Kinetic Perimetry ◽  
Field Of Vision ◽  
Finger Counting ◽  
Definition Of

• Glaucoma results in progressive visual field deterioration, and detecting changes or recording stability in the visual field is important in the management of glaucoma. • Visual field testing is a highly subjective and operator-dependent test. • In patients with glaucoma, the visual field is tested in monocular fashion. •The boundaries of the visual field (in a well-lit environment with an easily visible target) are grossly 60 degrees superiorly, 75 degrees inferiorly, 100 degrees temporally, and 60 degrees nasally. • Basic concept in determination of visual field is “threshold” •Definition of “threshold”: weakest test stimulus that is just visible in a particular location (stimulus intensity at which the patient responds 50% of the time) •Types of visual field testing strategies •Confrontation •Spot testing •Kinetic spot testing •Static spot testing •An initial screening tool to look for large and dense visual field defects that may be present in very advanced glaucoma •Both hands should be used in the testing processed. The patient should occlude the untested eye with the palm of the hand. •If the visual acuity will allow the finger counting technique, all four quadrants may be tested at 3 to 4 feet from the patient at an approximate 45-degree angle holding up either one or two fingers, or a whole hand. • If the visual acuity is HM or LP, then test for light perception in the respective 4 quadrants. • It is important that the patient be able to tell you where the light is located in the field of vision, not simply the presence of light. • Factors that affect the visibility of the spot • Size Intensity • Background illumination Others: color, movement, duration of presentation, attentiveness of the patient, and refractive state of the eye • Kinetic • Usually Goldmann perimetry (though some of the automated machines such as the Octopus will perform kinetic perimetry) • The perimetrist may adjust the location, size, and intensity of the stimulus throughout the test. •Useful in the following cases: Those who need coaching and an altered pace of testing (e.g., elderly, wheelchair-bound, or limited concentration)

The Learning Effect in Visual Field Testing of Healthy Subjects Using Frequency Doubling Technology

2002 ◽  
Vol 11 (6) ◽  
pp. 511-516 ◽  
Author(s):  
Amjad Horani ◽  
Shahar Frenkel ◽  
Claudia Yahalom ◽  
Marilyn D. Farber ◽  
Uriel Ticho ◽  
...  
Keyword(s):  
Visual Field ◽  
Healthy Subjects ◽  
Learning Effect ◽  
Frequency Doubling ◽  
Field Testing ◽  
Visual Field Testing ◽  
Frequency Doubling Technology

Delayed Detection of Predominantly Pericentral Hydroxychloroquine Toxicity in a Dominican Patient

2021 ◽  
pp. 247412642110342
Author(s):  
Saagar A. Pandit ◽  
Archana A. Nair ◽  
Nitish Mehta ◽  
Greg D. Lee ◽  
K. Bailey Freund ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Optical Coherence Tomography ◽  
Visual Field ◽  
Cystoid Macular Edema ◽  
Visual Fields ◽  
Field Testing ◽  
Visual Field Testing ◽  
External Limiting Membrane ◽  
Asian Patients ◽  
Sd Oct

Purpose: To describe delayed detection of pericentral hydroxychloroquine (HCQ) toxicity. Methods: 67-year-old Dominican woman with rheumatoid arthritis on HCQ presented for examination. Results: Spectral-domain optical coherence tomography (SD-OCT) demonstrated bilateral cystoid macular edema with parafoveal attenuation of the external limiting membrane (ELM) and the ellipsoid zone (EZ). ELM and EZ disruption was present in inferior macula. While subtle superior defects were present on 10-2 visual fields, superior pericentral defects were noted on 24-2 testing. Hyperautofluorescence along inferior arcades corresponded to SD-OCT and visual fields. Examination 2 years prior demonstrated nonspecific points of depression on 10-2 visual fields and normal central SD-OCT findings. EZ and ELM disruption was present in the perifoveal inferior macula. Conclusions: Early pericentral distribution of HCQ toxicity is not limited to Asian patients. Detecting pericentral HCQ toxicity involves reviewing entire macular cube on OCT. When OCT changes are suspected on parafoveal OCT B-scans, visual field testing with 24-2 may be more sensitive than 10-2.

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