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Apparent glaucomatous visual field defects caused by dermatochalasis
A S Kosmin1, P K Wishart, M K Birch
1Glaucoma Clinic, St Paul's Eye Unit, Royal Liverpool University Hospital, UK.
Eye (London, England)
|January 1, 1997
Summary
Dermatochalasis, or excess eyelid skin, can cause inaccurate visual field test results. Taping the eyelid or surgery can correct these defects, highlighting the need for careful examination during glaucoma screening.
Area of Science:
- Ophthalmology
- Visual field testing
Background:
- Ocular hypertensive patients can present with visual field defects.
- Dermatochalasis is a condition involving redundant upper eyelid skin.
Purpose of the Study:
- To investigate the impact of dermatochalasis on Humphrey automated perimetry.
- To determine if dermatochalasis can mimic glaucoma-related visual field defects.
Main Methods:
- Studied 15 visual fields from 9 ocular hypertensive patients (18 eyes).
- Performed Humphrey automated perimetry (24-2 programme).
- Repeated visual field tests with redundant upper eyelid skin taped up and, in some cases, after blepharoplasty.
Main Results:
- Found incongruous visual field defects in patients with dermatochalasis.
- Defects were primarily in the superior visual field, often supero-temporal.
- Field defects reversed upon taping the eyelid or after blepharoplasty, confirming dermatochalasis as the cause.
Conclusions:
- Dermatochalasis can significantly affect automated visual field testing accuracy.
- It may lead to misdiagnosis of conditions like glaucoma.
- Consideration of eyelid structure is crucial in interpreting visual field results.