Abstract
BackgroundThe purpose of this study was to compare the monocular Humphrey Visual Field (HVF) with the binocular Humphrey Esterman Visual Field (HEVF) for determining whether subjects suffering from glaucoma fulfilled the new medical requirements for possession of a Swedish driver’s license.MethodsHVF SITA Fast 24–2 full threshold (monocularly) and HEVF (binocularly) were performed consecutively on the same day on 40 subjects with glaucomatous damage of varying degrees in both eyes. Assessment of results was constituted as either “pass” or “fail”, according to the new medical requirements put into effect September 1, 2010 by the Swedish Transport Agency.ResultsForty subjects were recruited and participated in the study. Sixteen subjects passed both tests, and sixteen subjects failed both tests. Eight subjects passed the HEFV but failed the HVF. There was a significant difference between HEVF and HVF (χ2, p = 0.004). There were no subjects who passed the HVF, but failed the HEVF.ConclusionsThe monocular visual field test (HVF) gave more specific information about the location and depth of the defects, and therefore is the overwhelming method of choice for use in diagnostics. The binocular visual field test (HEVF) seems not be as efficient as the HVF in finding visual field defects in glaucoma subjects, and is therefore doubtful in evaluating visual capabilities in traffic situations.
Highlights
The purpose of this study was to compare the monocular Humphrey Visual Field (HVF) with the binocular Humphrey Esterman Visual Field (HEVF) for determining whether subjects suffering from glaucoma fulfilled the new medical requirements for possession of a Swedish driver’s license
All subjects who passed the HVF passed the HEVF, but eight subjects who received a “fail” score on the HVF passed the HEVF anyway. These eight subjects that failed according to HVF but passed according to the HEVF showed moderate glaucoma damage in the visual fields with an average Mean Deviation (MD) = −9.19 (SD = 3.44)
Results indicate that the HVF is still the predominant visual field test for the detection and diagnosis of visual field defects in glaucoma, but in the case of driver’s license screenings, the HEVF can be as effective as the HVF in detection of central defects in cases of advanced glaucoma
Summary
The purpose of this study was to compare the monocular Humphrey Visual Field (HVF) with the binocular Humphrey Esterman Visual Field (HEVF) for determining whether subjects suffering from glaucoma fulfilled the new medical requirements for possession of a Swedish driver’s license. The test consists of 120 white test points shown with equal, non-adjustable suprathreshold light intensity of 10 dB and examines more than 130° of the field This binocular method is useful in glaucoma patients with later stage bilateral visual field defects, and is used to assess the remaining visual ability or disability. Each location in the right monocular field has a corresponding point in the left monocular field and vice versa Disadvantages of this technique are that it is not possible to judge whether the defect is absolute or relative, and there is no way to control fixation stability since the binocular testing conditions eliminate naturally occurring blind spots which are used for fixation control in other tests
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