Balance between pattern and flicker sensitivities in the visual fields of ophthalmological patients

We measured the balance between visual sensitivities to pattern and to flicker rather than measuring absolute sensitivities to pattern or flicker. The test target was a 2-cycle deg-1 sinewave grating that was counterphase modulated at 8 Hz. Seventeen points in the visual field were tested out to eccentricities of 24 degrees. We examined 10 control subjects, 6 patients with glaucoma 10 with ocular hypertension, and 10 with multiple sclerosis. For controls pattern sensitivity was lower than flicker sensitivity in central vision. The converse held in peripheral vision. The balance between pattern sensitivity and flicker sensitivity was markedly abnormal in part or all of the visual field for many patients. There were examples in all patient groups. In some patients flicker sensitivity was depressed relative to pattern. In others the converse was true. Of 10 patients with ocular hypertension and no perimetric field loss 8 had a significantly abnormal ratio between pattern sensitivity and flicker sensitivity at some point in the visual field. The balance between pattern and flicker sensitivity was more sensitive to visual pathology than absolute sensitivity to either pattern or flicker. We conclude that the relationship between pattern and flicker sensitivity may be more sensitive to visual field damage than is conventional perimetry or visual acuity perimetry.