Visual field examination

Question 1

What is the gold standard test for visual fields?

Answer 1

formal perimetry

Question 2

What is a quick way of testing for gross homonymous VF defects in clinic?

Answer 2

patient with both eyes open and looking at bridge of your nose - ask if any part of face appears to be missing

Question 3

What is a quick way of testing for peripheral defects in clinic?

Answer 3

non-testing eye occluded, check they can see a white pin head against a dark background. map out R/L VF with the white pin (from unseen to seen, asking pt identify when first see the pin)

Question 4

What is a quick way of testing for central VF defects in clinic?

Answer 4

same as white pin peripheral test but use red pin to map R/L central thirty degrees (asking pt to identify when the pin appears red)

Question 5

What is a quick way in clinic to identify an enlarged/part of centrocecal scotoma?

Answer 5

use red pin to map out R/L central thirty degrees (asking the patient to identify when the pin appears red)

Question 6

What should be the next step if any VF abnoramlity is identified on screening clinic tests?

Answer 6

confirm it on formal perimetry

Question 7

What are 2 additional clinic tests for visual fields to consider?

Answer 7

• Test for inattention (stroke syndromes): simultaneous perception of gross targets
• simultaneous presentation of red targets across vertical and horizontal midlines

Question 8

What is an example of type of disease that may be elicited by presenting red targets simultaneously across vertical and horizontal midlines?

Answer 8

e.g. to identify temporal depression of red perception in early chiasmal disease