The Evolution of Visual Field Testing: A 40-Year Perspective on Modern Perimetry in Glaucoma

Area of Science:

• Ophthalmology
• Medical Technology
• Visual Neuroscience

Background:

• Visual field assessment has a long history, evolving from ancient concepts to 19th-century objective measurements.
• Early methods focused on peripheral vision (perimetry), later shifting to central field defects (campimetry) vital for glaucoma diagnosis.
• Historical techniques like Bjerrum tangent screen and Goldmann kinetic perimetry laid the groundwork for modern approaches.

Purpose of the Study:

• To review the evolution of modern visual field testing over the last 40 years.
• To highlight technological advancements in hardware, software, and testing paradigms.
• To examine the impact of these advancements on glaucoma care.

Main Methods:

• Review of historical and modern visual field testing methodologies.
• Focus on the transition to static automated perimetry (SAP) since the 1980s.
• Examination of technologies like the Humphrey Field Analyzer (HFA).

Main Results:

• Static automated perimetry (SAP) has become the clinical standard for visual field testing.
• SAP offers precise and reproducible quantification of visual field sensitivities.
• Technological progress has significantly enhanced the detection and management of glaucoma.

Conclusions:

• Modern visual field testing, particularly SAP, is indispensable for glaucoma diagnosis and management.
• Technological advancements have reshaped the approach to glaucoma care over the past four decades.
• Continued innovation in visual field testing promises further improvements in patient outcomes.