The four-meter confrontation visual field test

Confrontation visual fields have limited value in testing paracentral vision. We have used a four-meter confrontation test for several years at the Mayo Clinic for screening of the central field. This test can identify paracentral scotomas and macular sparing in a homonymous hemianopia. The optics of this technique parallel those of the two-meter tangent screen examination in which a scotoma is greatly enlarged by doubling the test distance. Although in common usage by some neuro-ophthalmologists, this simple technique is useful as an office screening device for evaluating paracentral vision.