The future of visual fields

Abstract

Perimetry forms an essential component of the assessment of visual function, particularly for glaucoma and neurological conditions affecting vision. Conventional automated perimetry though has limitations, including that it is disliked by patients, takes considerable time, particularly in those with poor vision, and is subject to visit‐to‐visit variability meaning a large number of tests are often needed to confidently detect change over time. Regrettably visual field testing is often performed less frequently than it should. Though imaging techniques such as optical coherence tomography (OCT) provide objective information about the structure of the retina and optic nerve head, imaging is not a substitute for assessment of visual field, and perimetry remains a measure more directly relevant to vision‐related quality of life.Several new perimetry devices are under development and evaluation including devices for home perimetry using virtual reality headsets or tablet computers, and devices which detect response to stimuli using eye tracking rather than relying on the patient pressing a button. Such technologies may allow a greater number of visual field assessments, potentially improving ability to detect change. Progress is also being made to optimize visual field test strategies and to combine information from tests of structure and function.