Name of the Procedure:

Visual Field Examination, unilateral or bilateral; Extended Examination (e.g., Goldmann Visual Fields, Quantitative Automated Threshold Perimetry)

Summary

A visual field examination assesses the width and depth of a person's field of vision. This extended examination involves detailed testing using specialized equipment to detect and measure blind spots and other vision anomalies, providing comprehensive data for diagnosing and managing eye conditions.

Purpose

The visual field examination is used to diagnose and monitor eye diseases such as glaucoma, macular degeneration, and retinal conditions. It helps to detect early vision loss and progression of disease, thus enabling timely and effective treatment.

Indications

• Unexplained visual loss or visual field defects
• Symptoms of peripheral vision loss
• Monitoring for conditions like glaucoma, optic neuropathy, retinal detachment, or stroke affecting vision
• Patients with a family history of glaucoma

Preparation

• No fasting required.
• Patients should bring their current glasses or contact lenses.
• Avoid eye makeup to prevent interference with the test equipment.
• Inform the doctor of all medications being taken.

Procedure Description

1. Patient is seated and their head positioned comfortably on a chin rest.
2. Depending on the method, either the Goldmann perimeter or an automated perimeter machine is used.
   • For Goldmann, a handheld light target of varying sizes and intensities is moved within the visual field and the patient signals when they see it.
   • For automated testing, the patient watches fixed points on a screen and presses a button each time they see a light flash.
3. The extent of vision is mapped out, plotting at least three isopters and checking the central 30 degrees of vision.
4. Results are analyzed to quantify any visual field loss.

Duration

Typically 30 to 60 minutes.

Setting

Outpatient clinic or ophthalmologist's office.

Personnel

• An ophthalmologist or a trained technician conducts the test.
• An ophthalmologist interprets the results and provides a report.

Risks and Complications

• Minimal risks; mostly limited to discomfort from sitting still and concentrating for the test duration.
• Rarely, patients may experience mild eye strain or fatigue.

Benefits

• Early detection and monitoring of vision problems.
• Aids in adjusting treatment plans based on the progression of eye conditions.
• Improves outcomes by preventing further vision loss through timely intervention.

Recovery

• No downtime; patients can usually resume normal activities immediately.
• If pupils were dilated for the exam, temporary light sensitivity or blurred vision might occur.
• Follow-up appointments may be scheduled based on results.

Alternatives

• Basic visual acuity testing: simpler but less detailed.
• Optical coherence tomography (OCT): provides cross-sectional images of the retina but does not measure the visual field.
• Pros of the visual field examination: more detailed, detects issues early.
• Cons: slightly longer and more involved than basic tests.

Patient Experience

• The procedure is non-invasive but requires focus and patience.
• Mild discomfort from the chin rest and head positioning.
• Light flashes may cause brief discomfort for some patients.
• Overall, the test is well-tolerated and painless.