Binocular Visual Field Test Research Articles

Glaucoma patients' assessment of their visual function and quality of life.

To determine how glaucoma and glaucoma suspect patients' rating of their vision correlates with Esterman binocular visual field testing and other visual function tests. One hundred ninety-one glaucoma patients and 46 glaucoma suspect patients underwent binocular visual field testing and evaluated their vision using the linear rating scale and time-tradeoff utility tests, the National Eye Institute Visual Functional Questionnaire (NEI VFQ-25), and the Short Form 36 (SF-36) quality-of-life instruments. The mean Esterman score was 88.2 +/- 17.4 for the glaucoma subjects and 95.2 + 6.9 for glaucoma suspect subjects (maximum score 100). On a scale from 0 (blind) to 100 (ideal), the mean rating of vision for glaucoma patients and glaucoma suspect patients was 74.8 +/- 17.3 and 78.9 +/- 18.5, respectively. The Esterman test correlated moderately with the overall NEI VFQ-25 score (partial correlation coefficient (PCC) = 0.32, P = 0.001), but only weakly with the linear rating scale (PCC = 0.17, P = 0.02), and the time-tradeoff (PCC = 0.14, P = 0.06). Utility values that glaucoma and glaucoma suspect patients assign to their vision do not correlate well with Esterman results. A challenge for the future is the design of clinical tests of vision that better correlate with patient perceptions.

Diagnostic Techniques in the Differential Diagnosis of Abduction Deficits

Having lots of diagnostic tests available to evaluate limitation of abduction does not warrant using them all on every patient. Sample questions are offered to help direct the history taking and best uncover the patient's presenting symptoms, chief complaint and past medical history. Only those diagnostic testing techniques which would benefit the individual patient are suggested as part of the diagnostic work up. Tests discussed include simple assessment and methods of documenting ductions and versions in infants and adults, OKN, Doll's Head Maneuver, prism and cover testing, clinical and formal EOG assessment of saccadic velocities, binocular visual field testing, Hess/Lees Screen, forced ductions, force generations, EMG, differential IOP, Tensilon® and dynamic MRI testing.

Esterman Disability Rating in Severe Glaucoma

Forty-two patients with severe visual loss from glaucoma were assigned an Esterman visual function score according to their performance on a binocular visual field test using an automated perimeter. (The Esterman score has been adopted by the AMA as a new standard for rating visual field disability.) The visual function score was correlated with patient responses to questions about perceived visual disability. Monocular visual field results from both eyes using automated suprathreshold static and manual kinetic perimetry were also compared to the binocular Esterman test results. The binocular Esterman test rapidly provided information concerning visual field disability which correlated well with combined monocular results, and with an objectivity lacking in patient responses to a disability questionnaire.