Computerized visual field screening in the management of patients with ocular hypertension

Visual field testing which the Computer fully automatic computerized perimeter (Heijl & Krakau 1975) employing a supra-liminal screening test procedure was used in a material of 1013 eyes with ocular hypertension in which earlier routine perimetry (kinetic and static) on the Goldmann perimeter had yielded a normal result. The automatic screening was repeated if positive, and manual control perimetry was used in order to confirm or reject identified field defects. This procedure revealed field defects that could be confirmed at both automatic and manual perimetry in 3.6% of the eyes. In the control group the incidence of field defects found at manual perimetry during the same time interval was calculated at 0.4%. Thus automatic screening revealed several times more field defects than manual routine perimetry. Eyes in which repeated automatic screening had indicated defects which manual control perimetry failed to confirm, showed a high percentage of field loss at later follow-up. The results are discussed, and the conclusion is drawn that automatic screening is clearly superior to manual routine perimetry used at present. The most practical solution in many eye departments would be to use a computerized perimeter for the visual field screening of glaucoma suspects.