gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Is the new scoring system according to a modified Esterman grid reliable for the assessment of functional impairment of visual field defects?

Meeting Abstract

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  • corresponding author G.H. Kolling - Department of Strabismology and Neuroophthalmology, University-Eyeclinic, Heidelberg

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogFR.07.06

The electronic version of this article is the complete one and can be found online at:

Published: September 22, 2004

© 2004 Kolling.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.




In German "Soziale Entschädigungs-Recht" and in German private and general insurances, there exist fixed values for different geometrically defined visual field defects. The newly modified method of Esterman [1] is independent of geometrically fixed defects and is tested reexamining the last cases of the university eyeclinic.


For the last 30 cases of assessment for insurances we have reevaluated the assessment by the old and the new system. The old system is published by the German Ophthalmological Society in accordance with the German 'Berufsverband der Augenärzte Deutschlands'. On the other hand, the new system of Weber, Schiefer and Kolling is independently evaluating the field defects and gives detailed values of the visual field deficits. In over 2/3 of the cases the scores of the new and of the old system are more or less identical. In the "Soziale Entschädigungs-Recht" the desired steps are +/-10%, so that the differences are great enough to get the same result. Only in cases with not regular visual field defects within the lower 50 degrees of the visual field the newly proposed system is recommended by social insurances. According to the new publications of private insurances, the new system can be applied to visual field defects of cortical origin, i.e. in cases of homo- or heteronym character.


The new system can help to estimate visual field defects in an objective way. In most cases the level of functional impairment is almost identical in both systems. Sometimes the new system seems to be have a better logical background than the old one, especially in bitemporal visual field deficits.


A new scoring system according to the method of Esterman for assessment of functional impairment by visual field defects. Weber J, Schiefer U, Kolling G. In: Der Ophthalmologe 2004, in press.