Confrontation visual field testing
| Confrontation visual field testing | |
|---|---|
| Purpose | For rapid detection of large-scale visual field problems |
Confrontation visual field testing is a test used in ophthalmology for rapid and gross detection of large-scale visual field problems. It is done by asking the patient looking directly at examiner's eye or nose and compare patient's visual field with examiner's. field. It can be used to test the binocular visual field (with both eyes open) and or visual field of each eye separately (with one eye closed).
Indications
Confrontation visual field testing can be used for rapid and gross assessment of large-scale visual field problems, such as homonymous and heteronymous hemianopias, quadranopsia, altitudinal visual loss, central/centrocecal scotoma etc.[1][2] Test using a red target can detect red-desaturation, a sign of early optic nerve disease.[3]
Procedure
Confrontation visual field testing did not need a clinical setting to perform. It can be done in any well illuminated room. Since visual fields of both eyes overlap in the nasal area, each eye is tested separately.[4][5] Patient is asked to sit in front of the examiner, at a distance between 66-100 cm, maintaining the eye level same as examiner's.[1] Patient is asked to remove his/her spectacles before starting the test. For testing right eye field, patient is asked to close his left eye, and look straight at the examiner's left eye (preferably) or nose.[1] Examiner should also close his/her right eye.[1][6] Move a finger or bead-on-a-stick inwards from an area outside the usual 180º visual field, and ask the patient when they first see the targets.[1][7] Alternatively, patient may be asked to count the number of fingers the examiner shows, or identify wiggling fingers.[6] For an accurate assessment of the patient's visual field, it is essential that the distance of all test objects from the patient is the same as the distance from the examiner.[6] Examiner should compare this point with his own visual field.[1] Repeat the procedure for all eight meridians.[1]
Record the type of target used and whether any significant abnormalities in patient's visual field. Colored targets such as red are more sensitive than a white test targets.[5]
Confrontation testing can be done with both eyes open also. It is done for testing the binocular visual field.[3]
Advantages and disadvantages
The Confrontation visual field testing is a simple, easy, quick and inexpensive clinical technique that can be used for gross assessment of large-scale visual field problems, such as homonymous and heteronymous hemianopias, quadranopsia etc.[1] But testing is less useful for detecting arcuate scotoma and bitemporal hemianopsia.<ref name="Johnson"> To compare patient's visual field with own visual field, examiner should have a full field of vision.
References
- ^ a b c d e f g h David B., Elliott (2007). "Assessment of visual function". Clinical procedures in primary eye care (3rd ed.). Elsevier/Butterworth Heinemann. pp. 68–69. ISBN 9780750688963.
- ^ Johnson, L. N.; Baloh, F. G. (October 1991). "The accuracy of confrontation visual field test in comparison with automated perimetry". Journal of the National Medical Association. 83 (10): 895–898. ISSN 0027-9684.
- ^ a b Broadway, David C; Kyari, Fatima (2019). "Examining visual fields". Community Eye Health. 32 (107): 58–59. ISSN 0953-6833.
- ^ "Confrontation Visual Fields". webeye.ophth.uiowa.edu.
- ^ a b "Visual Field Testing Technique: Confrontation Testing, Simultaneous Confrontation Testing, Perimetry". emedicine.medscape.com.
- ^ a b c Pollock, Stephen C. "Confrontation Visual Fields A Concise Guide for Ophthalmologists in Training" (PDF).
- ^ "Visual Field Test". American Academy of Ophthalmology. 10 March 2022.