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The effect of glaucoma on central visual function.

R L Stamper

    Transactions of the American Ophthalmological Society
    |January 1, 1984
    PubMed
    Summary
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    Early glaucoma can impact central vision, challenging traditional beliefs. Research indicates defects in color perception and contrast sensitivity may occur even before peripheral visual field loss is detected.

    Area of Science:

    • Ophthalmology
    • Neuroscience
    • Visual Science

    Background:

    • Traditional view: Glaucoma affects peripheral vision early, sparing central vision until late stages.
    • Basis of tradition: Reliance on Goldmann perimetry (peripheral) and Snellen acuity (central).
    • Patient reports: Glaucoma patients often report central vision disturbances, contradicting traditional views.

    Purpose of the Study:

    • To challenge the assumption that glaucoma spares central vision in early stages.
    • To investigate central visual functions, including color perception and contrast sensitivity, in glaucoma patients.
    • To assess if central visual defects precede peripheral visual field abnormalities.

    Main Methods:

    • Histologic examination of retinal nerve fiber layer in glaucomatous eyes.

    Related Experiment Videos

  • Assessment of afferent pupillary defects as a measure of macular function.
  • Testing of color perception using a desaturated D-15 color panel (central 1.5 degrees).
  • Evaluation of both chromatic and achromatic foveal perception channels.
  • Measurement of spatial and temporal contrast sensitivity.

    • Main Results:

    • Histologic evidence suggests decreased ganglion cells in early glaucoma, impacting macular function.
    • Afferent pupillary defects may be present in early glaucoma.
    • Color perception defects are common in early glaucoma, sometimes preceding visual field loss (78% of patients with early visual field defects had color perception issues).
    • Both chromatic and achromatic foveal perception are impaired in glaucoma and suspected glaucoma.
    • Spatial contrast sensitivity appears reduced in glaucoma, though current tests lack clear distinction.
    • Reduced temporal contrast sensitivity was investigated in a systematic study.

    Conclusions:

    • Glaucoma may affect central visual functions, including color perception and contrast sensitivity, earlier than previously assumed.
    • Central visual defects, particularly in color vision, can precede detectable peripheral visual field loss.
    • Further investigation into central visual function, especially temporal contrast sensitivity, is warranted for early glaucoma detection and management.