[How to assess the stability of glaucoma? Visual field]

Visual field results are subject to fluctuations in glaucoma and it is important to evaluate them to differentiate fluctuation and progression. Three visual fields are thus required for the determination of progression because of these short or long term fluctuations. During each measurement, some points are tested twice in order to assess short term fluctuation. Other fluctuations are simply due to technical difficulties like a change of position of the head from one examination to the next one. Learning effect is in fact the more important factor which may improve results. However some real long term fluctuations exist, mainly as a function of the general health of the patient. Progression of the visual field is usually assessed by subjective analysis of the fields with an evaluation of the intensity and the size of scotomas and a comparison of global indices. A more objective analysis can be obtain by the use of specific programs like the "Glaucoma Progression Analysis" with the Humphrey Perimeter or the "Progressor" with the Octopus Perimeter.