Evaluating for unrecognized deficits in perimetry associated with functional upper eyelid malposition

Area of Science:

• Ophthalmology
• Glaucoma Research
• Oculoplastics

Background:

• Glaucoma patients may have functional upper eyelid malposition.
• Automated perimetry is crucial for glaucoma diagnosis and management.
• Eyelid malposition can potentially interfere with visual field testing.

Purpose of the Study:

• To determine if functional upper eyelid malposition is associated with unrecognized visual field deficits in glaucoma patients.
• To examine glaucoma patients undergoing eyelid surgery who did not require eyelid taping during prior visual field tests.

Main Methods:

• Retrospective pre-post study design.
• Inclusion of patients with reliable visual field testing before and after eyelid surgery (blepharoplasty or ptosis repair).
• Exclusion of patients with comorbid ocular diagnoses and those whose visual fields required eyelid taping.

Main Results:

• No statistically significant change in visual field parameters (mean deviation, pattern standard deviation) after eyelid surgery.
• No association found between margin reflex distance-1 and change in mean deviation in patients with ptosis.
• Five eyes with unreliable pre-operative visual fields showed significant improvement post-surgery.

Conclusions:

• Functional upper eyelid malposition does not appear to cause spurious visual field abnormalities in glaucoma patients with reliable visual fields.
• Unreliable visual fields in glaucoma patients may indicate underlying eyelid interference.