Presentation on theme: "Visual field examinations Week 6 Interpreting of visual fields."— Presentation transcript:
Visual field examinations Week 6 Interpreting of visual fields
Interpreting the data Is it a legitimate defect? ( tech or patient error) Is the defect in one or both eyes? What part of the pathway is effected because of the defect shown? Does the VF make sense? (Compared to the patient complaints and Dx.) Is there another VF to compare with this VF?
Is this a legitimate defect? Technician error Wrong corrective lens Poor instruction to patient Forgot to patch patient’s eye Lens holder to far from eye Doing the wrong test Entering wrong birthday Dilating or not dilating pupil Is it a depression, scotoma, or neurologic defect?
Technician error Lens holder to far away from eye. Wrong birth date
Technician error 30-2 vs central 10 Poor patient instruction- false positives
interpretation Is there a defect in one eye or both eyes? If there is a defect in only one eye, it will be before the chiasm. It can be retinal, glaucomatous, or nerve If there is a defect in both eyes, is it congruent or incongruent? If both eyes, is it neurological (chiasm and beyond) or same problem in both eyes ?
Interpretation of Visual Fields What part of the pathway has caused this defect? Both eyes: glaucoma hx? Trauma? Macular degeneration? Do the defects have horizontal or vertical respect? Retinal, macular, nerve and glaucoma are considered to be the same problem happening in both eyes. Defects that happen at or after the chiasm are effecting both eyes, but are a neurologic problem.
Interpretation of visual fields Pseudotumor causing papilledema Bitemporal hemianopia
Interpreting visual fields Left eyeRight eye
Interpreting visual fields 4 VF’s, you tell me! Both eyes effected, you tell me what’s wrong!
Interpreting visual fields Right and left eyes both have a problem- What is wrong?
Depression, step or scotoma? Interpreting visual fields
Interpretation of visual fields Does this VF make sense? If the patient came in for a 6 month repeat VF because of glaucoma, does this field match the Dx?
Interpretation of visual fields Are there other VF’s stored in the computer to compare with the most recent VF? This is a printout of all the VF’s this patient has taken. With this printout of ALL VF’s taken, it is easy to see how the glaucomatous defects have progressed. If something is out of the ordinary from what you expect- this comparison is a great way to look at all the past VF’s to figure out the problem.
Interpreting glaucomatous field defects Generalized depression Arcuate scotoma
Interpreting glaucomatous field defects Nasal stepTemporal wedge