Visual field testing

A 65-year-old male complains of losing his vision Retinal examination reveals optic nerve cupping. Peripheral vision loss is observed on visual field tests, and his intraocular pressure is increased. Following treatment with a drug, he has improved visual acuity and decreased intraocular pressure. 

Visual field testing and color vision testing... 

Ophthalmic effects Irreversible retinal damage has been observed in some patients who had received long-term or high-dosage 4-aminoquinoline therapy for discoid and SLE or RA. When prolonged therapy is contemplated, perform initial (baseline) and periodic (every 3 months) ophthalmologic examinations (including visual acuity, expert slit-lamp, funduscopic, and visual field tests). 

Nasal budesonide or beclomethasone 100 micrograms bd for 3-9 months had no effect on the eyes in 26 patients who had undergone endoscopic sinus surgery (440). Ophthalmologic examination, tonometry, visual field testing, and biomicroscopic studies showed no evidence of ocular hypertension or posterior subcapsular cataract. 

There has been a report of retinal changes in 60 users of crack (164). Microtalc retinopathy and retinal nerve fiber layer rake or slit defects were detected by threshold visual field testing and fundus photography. 

John L, Kelmer JL. Normal visual field tests following glaucomatous visual field endpoints in the Ocular Hypertension Treatment smdy (OHTS).Arch Ophthalmol 2005 123 1201-1206. 

Visual field defects are difficult to detect by simple clinical examination, even in patients with severe constriction at perimetric assessment. Visual field testing should be done before treatment and at regular intervals thereafter. Patients should be questioned about visual disturbances and referred to an ophthalmologist if relevant symptoms are recognized. 

The long-term retinal effects of vigabatrin in children are unknown, and visual field testing is usually impossible. Recent evidence has suggested that a short course of vigabatrin (6 months) in children with infantile spasms may be sufficient (54) and minimizes the potential for visual adverse effects. 

Aidman Vision Screener. The aidman vision screener is an informal test that can be used to assess the function of the eye by an army medic. The test(s) are function based and result in evacuation recommendations. The tests consist of a near visual acuity test, such as a random E chart or Snellen chart (Figure 6-H), and an Amsler Grid (Figure 6-1) visual field test. For soldiers who report being exposed to a laser source, the aidman screener offers a quick laser injury recognition tool (Table 6-F). 

Visual field testing 0 No visual field loss... 

Visual field testing SCORE 0 No visual field loss 1 Partial hemianopia 2 Complete hemianopia 3 Bilateral hemianopia (bhnd including cortical blindness)... 

Sensory systems Vision A 54-year-old male kidney transplant patient developed bilateral ischemic optic neuropathy while taking tacrolimus [143 ]. The right fundus was normal, but there was temporal pallor of the left optic disc. A Goldmann visual field test showed cecocentral scotoma with an inferior predilection in both eyes. Fluorescein angiography showed no fluorescence filling the optic disc in either eye, from the early phase to the late phase, which suggests absolute absence of blood flow to the optic disc. Visual acuity improved partially after withdrawal of tacrolimus. 

Reduced visual acuity and central or centro-cecal scotomas on visual field testing have been reported as the usual presentation of eth-ambutol-induced optic neuropathy. Bilateral temporal hemianopia has been reported in a case of ethambutol toxicity [64 ]. 

Hawkins, A. S., J. P. Szlyk, Z. Ardickas, A. Ziba, K. R. Alexander and J. T. Wilensky (2003). Comparison of Contrast Sensitivity, Visual Acuity, and Humphrey Visual Field Testing in Patients with Glaucoma. J. Glaucoma, 12(2), 134-138. 

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