gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Visual field in patients with severe visual handicap

Meeting Abstract

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Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.07.05

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Veröffentlicht: 22. September 2004

© 2004 Wilhelm.
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Even with normal visual acuity a patient is considered as legally blind if his visual field is smaller than 5 degrees radius. Because of the social and financial consequences exact testing of the visual field is mandatory. However, determining the visual field size is not possible with sufficient precision. Perimetry results are influenced in many ways: Ability and willingness of the patient to cooperate, experience and skill of the examiner, state of the perimetry device, pupil size, fixation behaviour and more.

Incorrect results are therefore common. Without any doubt, only kinetic perimetry is applicable, either with the Goldmann perimeter or a system with analogue function. Automated grid perimetry is not suited for the purpose of measuring a small visual field. Testing for plausibility is mandatory. Perimetric findings must be explainable by objective findings. If this is not the case additional objective examinations are necessary. Multifocal ERG (Sutter) enables objective perimetry in case of a retinal disease. Multifocal VEP is a future option of this system. Pupil perimetry is helpful in many cases. No procedure, however, is able to measure the size of a small visual field exactly. The synopsis of several subjective and objective methods is required.