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Continuous visual field test supervision may not always be necessary

R E Van Coevorden1, R P Mills, Y Y Chen

  • 1Department of Ophthalmology, University of Washington, Seattle 98195-6485, USA.

Ophthalmology
|January 26, 1999
PubMed
Summary
This summary is machine-generated.

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Supervision improves overall reliability in visual field testing for glaucoma patients. However, it is only necessary for individuals with risk factors like advanced age or low education.

Area of Science:

  • Ophthalmology
  • Neuro-ophthalmology

Background:

  • Computerized visual field (VF) testing is crucial for diagnosing and monitoring glaucoma and neuro-ophthalmic conditions.
  • The impact of technician supervision on VF test performance and reliability requires further investigation.

Purpose of the Study:

  • To evaluate the effect of supervision on computerized visual field (VF) test performance.
  • To identify patient characteristics associated with poor performance during unsupervised VF testing.

Main Methods:

  • A randomized, crossover, clinical trial involving 200 patients with glaucoma or neuro-ophthalmic indications.
  • Patients underwent two 30-2 VF tests per eye: one supervised and one unsupervised after initial familiarization.
  • VF reliability parameters and global indices were measured using Humphrey perimeters.

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Main Results:

  • Supervision positively impacted overall VF test reliability (P=0.04) but did not affect individual reliability metrics or global VF indices.
  • Predictors for needing supervision included lower educational attainment and prior false-positive results.
  • Advanced age and a high rate of fixation loss in previous tests predicted unreliable results.

Conclusions:

  • Supervision is recommended for patients with risk factors such as advanced age, low education, or prior unreliable test results (high false positives or fixation losses).
  • For patients without these risk factors, omitting supervision may be a viable option, potentially improving testing efficiency.