How can physicians maximize the utility of visual field testing?
What drives me nuts is seeing clinicians test—sometimes for 10 to 20 years—the entire central 30° of the field of a patient who only has a 10° field. That testing yields little information and makes the patient feel hopeless, because he or she does not see the light for a long time, if ever. Unfortunately, this approach to testing is what doctors are taught. Visual field testing should be tailored to the patient’s stage of disease. For example, for someone with tunnel vision, the field should only cover the central 10°. This strategy will produce far more accurate data, and the patient will feel better about the test and be less fatigued. It is a win-win situation. Another pearl is to use a larger test object (stimulus size V vs III) if the patient’s visual field is very damaged but in a generalized way. Suddenly, the physician may uncover a large portion of the visual field that he or she thought was blind but is not. The clinician can then help to preserve that vision. In terms of th
