Effect of simulated altitude on the visual fields of glaucoma patients and the elderly

We investigated whether mild hypoxia, such as may be encountered in civilian aircraft, causes temporary visual field defects in elderly persons or temporarily increases pre-existing defects in persons with glaucoma. The central 24-2 program on the Humphrey automated perimeter was used to test visual fields in 3 groups of subjects: 6 with glaucoma; 12 age-matched controls, all of whom were over 44 years of age; and 6 normal subjects under 36 years of age. Visual fields were tested at ground level and at simulated 3000 m (10,000 ft) in an alternating sequence. A repeated measures design of multiple analysis of variance was used to analyze the data. Altitude was found to have no effect on the visual fields of subjects with glaucoma, age-matched normals, or younger subjects. We found no evidence to suggest a change in the present Federal Aviation Administration (FAA) standards, which allow a special certificate to be issued to persons with glaucoma who wish to obtain medical clearance to operate civilian aircraft, nor have we found any evidence that should discourage glaucoma patients from flying as passengers.