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Doctor insights on: Abnormal Visual Field Test

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How often should you have a visual field test when you have glaucoma?

How often should you have a visual field test when you have glaucoma?

Visual field test: In stable glaucoma, normally done once a year to verify that no change for the worse is occurring. If so, treatment will be intensified. If your glaucoma is unstable, or a change in the optic nerve is noted, a visual field is done at that time even if already done that year. Visual fields are measured besides the optic nerve cup/disc ratio, intraocular pressure, and nerve fiber layer. ...Read more

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Why is it that I do poorly on visual field test using a frequency doubling perimetry machine but test results are much better using Humphrey machine.

Why is it that I do poorly on visual field test using a frequency doubling perimetry machine but test results are much better using Humphrey machine.

Complex question.: This complex question is best answered by an Ophthalmologist (one who knows your condition & knows you best). In general, there are 2 types of perimeters (devices which measure visual fields). There are kinetic perimeters, like the frequency doubling machine, & the static perimeters (like the Goldman method, Humphrey machine, & Donder's test). If you can't see flickers, you do worse on kinetics. ...Read more

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In glaucoma annual exam I have Humphrey visual field test but not the Goldman test that measures wider field. Is it a good idea to have both tests?

In glaucoma annual exam I have Humphrey visual field test but not the Goldman test that measures wider field. Is it a good idea to have both tests?

Not an issue: Visual field tests are helpful in the early diagnosis of glaucoma. Disc evaluation is more useful in the middle phases and visual field becomes the only marker later when the disc is maximum. The Humphrey is standardized against the Goldmann and either test is useful when sequential tests are run. It does not usually matter which is done and some cannot do the Humphrey well. ...Read more

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I've been on 400 mg Plaquenil fo 6 years. No signs of toxicity. In general, how often should I have 10-2 visual field test? every year?Every 6 months?

I've been on 400 mg Plaquenil fo 6 years. No signs of toxicity. In general, how often should I have 10-2 visual field test? every year?Every 6 months?

Hydroxychloroquine: As a rheumatologist, I have patients on Plaquenil for years. At the doses we now use, side effects are rare. I think all patients, on Plaquenil or not, should have an eye exam once a year. I would be happy to consult with you, if you have any more specific questions. ...Read more

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Have Macular pucker causes white to appear gray. Also have glaucoma. Will visual field test be inaccurate because background is gray instead of white.

Have Macular pucker causes white to appear gray. Also have glaucoma. Will visual field test be inaccurate because background is gray instead of white.

Likely to be fine: There can be multiple conditions in an eye at one time, and when this is the case a visual field may be a bit off from it's full potential. But it can still give useful information. In your case, if it is inaccurate, some changes can be made to the settings of the test to make it easier. If still inaccurate, there are still other parameters/tests of your eye that can be utilized to follow it. ...Read more

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In glaucoma exam what does it mean when Dr. says there is "questionable change" to the optic nerve. No change in visual field test.

In glaucoma exam what does it mean when Dr. says there is "questionable change" to the optic nerve. No change in visual field test.

Progression: changes in the optic nerve are hard to quantitate changes in the visual field are more definitive but you do not want to wait until that happens it is time to be more aggressive in your glaucoma therapy ...Read more

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I had visual field test with 0 fixation losses and 0 false positives- 0false Neg felt my eye maybe moved around.is field accurate still? NML

I had visual field test with 0 fixation losses and 0 false positives- 0false Neg felt my eye maybe moved around.is field accurate still? NML

Good result: With zero fixation losses and zero false positives, your performance at the test was likely to be flawless and the results fully reliable. ...Read more

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Visual field test normal w/minimal peripheral vision loss. After diagnosed w/glaucoma feel more nervous driving such as changing lanes. Psychological?

Visual field test normal w/minimal peripheral vision loss. After diagnosed w/glaucoma feel more nervous driving such as changing lanes. Psychological?

MAYBE: Ask ophthalmologist to check visual accuity. If there has been no change, youre getting unnecessarily anxious. Remember the possibility of trouble doesn't mean it's there now. ...Read more

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Is it possible to get accurate visual field test with macular pucker decline in visual acuity, lights less bright & white computer screen looking gray?

Is it possible to get accurate visual field test with macular pucker decline in visual acuity, lights less bright & white computer screen looking gray?

Usually it is fine: You have defects in the central visual portion of your field of view - an area poorly outlined by most field testing devices. Field tests will define major defects which largely will register from the peripheral areas tested. Have you had a field tested in the past? Is there some condition being sought for with a field.? Your ophthalmologist would not order a field if he doubts the result. ...Read more

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Can a large eye floater affect peripheral vision in a visual field test.

Can a large eye floater affect  peripheral vision in a visual field test.

Yes: Visual field testing will occasionally pickup small areas of visual field depressions if the floater is particularly large and thick, as some patients may have. Since they move, a repeat visual field should also show the depression to have moved. I would not however expect a large visual field abnormality from a floater and certainly l recommend an exam to rule out any problems by an eye md. ...Read more

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Two eye drs. Looking at visual field test result. One dr says it is normal & other says there's peripheral vision loss. Why the difference of opinion?

Two eye drs. Looking at visual field test result. One dr says it is normal & other says there's peripheral vision loss. Why the difference of opinion?

Interpretation: Interpretation of visual field change is somewhat subjective. As many as 5 cosequetive visual fields are necessary to show change over time. Peripheral changes can have a lot of "noise" in deciding whether or not it is real defect or not. Repetition of field testing and confirmation of defect over time is more accurate. Even then, there are many factors that can interfere in vf assessment. ...Read more

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Have glaucoma w/30% optic nerve damage. Being treated with eye drop that has lowered pressure. Visual field.Test good. What is prognosis long term?

Have glaucoma w/30% optic nerve damage. Being treated with eye drop that has lowered  pressure. Visual field.Test good. What is prognosis long term?

Good: Glaucoma is a treatable disease. If you are attentive to use the meds prescribed, have the pressure checked and periodic visual field your disease is well followed. If there is any tendency toward worsening there are other surgical option to address is. ...Read more

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How likely is it 2light periods being caused by pituitary tumor? No symptoms- visual field test NML &vision 20/20- CMP, CBC- NML, been very stressed

How likely is it 2light periods being caused by pituitary tumor? No symptoms- visual field test NML &vision 20/20- CMP, CBC- NML, been very stressed

Very unlikely: I'm not an endocrinologist, but I can tell you that pituitary tumors are very rare. Without symptoms (& your visual fields are normal, no lab abnormalities, I presume without daily persistent headaches), I would put your odds even lower for macroadenoma (large tumor). Small tumors that release hormones should cause other symptoms like diabetes, blood pressure, &c. At your age, I wouldn't worry. ...Read more

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Can you tell me about the visual field test?

Benign and painless: In this test you will sit looking at a dome on which lids are arrayed or a light is projected Your identification is by a signal button and the mapping of what you saw is produced as a clue to changes in glaucoma, or to the nervous system. ...Read more

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Visual field test 2 mos. Apart w/fixation loss of 6/12 in 1st test & 3/14 in 2nd test. 1st test showed more damage than 2nd. Which test is most right?

The second : Less fixation losses on the second test means you were focusing on the fixation target more times than on the first test. Therefore, the second is the most accurate test. ...Read more

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Can having excessive amounts of caffeine cause you to fail the visual field test,?

Can having excessive amounts of caffeine cause you to fail the visual field test,?

No: Caffeine consumption does not interfere with your visual field data. If, however, you are extremely jittery, you may be more nervous and overly responsive with the hand held clicker which may lead to higher percentage of false positives and fixation losses. The latter decreases the reliability of the visual died results. ...Read more

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Just had my annual plaquenil exam with OCT. All normal. Now I have to come back for a 10-2 visual field test. Isn't this normally all done on 1 visit?

Depends: Offices run with various schedules and demands. I would guess that the field machine to do the 10-2 field test was in use when you were in the office and instead of having you wait some period of time before the test, that they could schedule that test alone at a later date so you would not have to wait. Other offices might schedule all tests on one visit- best to ask prior to next appointment. ...Read more

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In monitoring open angle glaucoma, if oct test results taken 1 yr. Apart are different, can it mean glaucoma isn't stable? No change in visual field.

Open angle glaucoma: By definition will diminish your retinal nerve fiber layer (rnfl) over time if not well controlled. Serial rnfl scans are highly sensitive and can detect small changes prior to a formal visual field test demonstrates changes. Questions if loss is occurring can be answered by looking at serial scans of the rnfl over time and looking for trends. So, yes, it may not be stable and requires follow up. ...Read more

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Just saw eye doc for plaquenil exam.Now have to go back in a week for 10-2 visual field study. Is this a quick test or do I need to see doc again?

Just saw eye doc for plaquenil exam.Now have to go back in a week for 10-2 visual field study. Is this a quick test or do I need to see doc again?

Yes to visual field: In general plaquenil is a very safe medication. The recent guidelines are to get a baseline eye exam when starting plaquenil and then once per year. They are screening you for a rare complication from plaquenil called maculopathy. This is very rare but the rate slightl goes up after being on the drug after 5 years. So yes go get the visual field test. ...Read more