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Modified visual field test for ptosis surgery (Leicester Peripheral Field Test).
S F Ho1, A Morawski, R Sampath
1Department of Ophthalmology, Leicester Royal Infirmary, Leicester, UK. s_ho2@yahoo.com
Eye (London, England)
|January 22, 2011
Summary
A new visual field test effectively assesses functional vision loss from ptosis and dermatochalasis. Surgery significantly improves visual field defects, supporting these procedures as medically necessary treatments.
Area of Science:
- Ophthalmology
- Ophthalmic Surgery
- Visual Field Testing
Background:
- Lack of consensus exists regarding reimbursement for ptosis surgery and upper lid blepharoplasty, often deemed cosmetic.
- Standardized photography is costly and difficult; routine 24-2 visual fields lack sensitivity for superior field defects.
- Ptosis and dermatochalasis can cause significant functional visual impairment.
Purpose of the Study:
- To introduce a modified visual field test for assessing functional disability in ptosis and dermatochalasis.
- To evaluate the effectiveness of surgical intervention in improving visual fields for these conditions.
Main Methods:
- Prospective study of 97 patients (194 eyes) undergoing ptosis or dermatochalasis surgery (Jan 2006-Dec 2009).
- Patients performed a modified visual field test pre- and post-operatively.
- Procedures included aponeurotic repair and/or blepharoplasty.
Main Results:
- The modified test demonstrated 98.8% sensitivity in detecting ptosis.
- 84.2% of patients with ptosis surgery showed improved points seen, and 81% improved visual field height.
- 90.9% of patients with blepharoplasty alone showed improved points seen, and 80.6% improved visual field height.
Conclusions:
- The modified visual field assessment is a rapid and simple tool for evaluating ptosis and dermatochalasis-related disability.
- Surgical correction significantly improves visual field deficits, confirming a functional basis for these conditions.
- Findings support classifying ptosis and dermatochalasis surgery as functional rather than purely cosmetic interventions.
