《视光学》视野检查.ppt

* The kinetic stimulus comes from the side to enter into vision of the patient. It is clear that because of the steepness of the field in the periphery, the borderline of seeing and not seeing is quite abrupt. This makes kinetic perimetry a perfect method for testing the peripheral field. However it is easy to miss a scotoma defect. Obviously, for opposite reasons, the static method is the best method to test the central field. * Test strategies represent the method to determine the results. Different ways of testing produce also differences in the result. Generally, the longer it takes the more accurate the data. * Here are the classic normal threshold test strategies. They produce the most accurate results but it may take long to finish with one eye. For this reason the first OCTOPUS examination program no. 32 was designed with 76 locations to not last longer than about 20 minutes. Currently more efficient strategies and test programs are implemented and used by the OCTOPUS perimeters. * A typical screening test can at best separate normal from suspect. If the results are not normal an additional threshold examination must determine the degree of pathology. The most common glaucoma programs to examine the central visual field are the 30-2 and the 24-2. (Just as a side note, the ?-2? stands for second version. The first version of the programs were on-axis programs, but since glaucoma respects the horizontal midline and neuro-ohthalmic diseases respect the horizontal and vertical midlines, these should be avoided for testing and hence the test pattern was moved off center. * The 24-2 is a subset of the 30-2 which was chosen for various reasons: First of all, Visual Fields are done with refractive correction (which applies to virtually all visual fields of patients above the age of 40 years, due to beginning presbyopia). However, if the lens is not positioned close enough to the patient’s eye (usually no more than around 15mm) the results are prone to so called le