Feasibility and outcome of automated kinetic perimetry in children

Visual field testing in children is often performed using a Goldmann perimeter. Because the technique is performed manually, it is difficult to standardize, and stimuli are often presented too quickly. Automated kinetic perimetry has been successfully established in adults, but to date no results have been published in children. This paper describes the feasibility and outcome of automated kinetic perimetry in children in a standard clinical setting.

Fifty children aged 5-14 years were examined using a Twinfield perimeter (Oculus Inc., Wetzlar, Germany), including healthy children, children with unilateral pathologies (normal eye tested) and children with unilateral strabismus (non-affected eye tested). Kinetic perimetry was performed using stimuli III(4), I(4), I(2) and I(1) (Goldmann standard) with a test velocity of 2 degrees/s. Whenever possible, each test was performed twice. Automated and/or manual re-testing was possible on the same device whenever indicated.

Automated kinetic perimetry took about 3.5 min per eye and could be completed more quickly than manual Goldmann perimetry, despite the lower test velocity. All children--with the exception of one 11 year old--were able to perform the test at least once. There was no significant correlation between age and the isopters or the area inside the isopters. No significant difference was found between children with and without strabismus.

In 49 out of 50 children (98%) automatic kinetic perimetry was possible in a clinical setting using a commercially available Twinfield perimeter in a session of clinically practical duration. A major advantage is constant test velocity, independent of the examiner. Test performance was not only dependent on age, but also on the child's maturity and ability to concentrate. Older children tended to detect the stimuli more peripherally. Older children got better results from the examiner evaluation parameters attention and central fixation.