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Visual field test

Visual field test (perimetry) — map-based assessment of central and peripheral vision.

A core diagnostic test for glaucoma follow-up that measures central and peripheral vision by responding to light stimuli appearing in different zones while you fixate on a central point.

Indication

  • Diagnosis, staging, and monitoring of treatment response in glaucoma
  • Evaluation of optic nerve disorders (optic neuritis, optic atrophy)
  • Screening for visual field loss caused by pituitary adenoma and other intracranial masses
  • Assessment of visual pathways in neurological diseases such as stroke and multiple sclerosis
  • Monitoring visual field loss in retinal diseases (retinitis pigmentosa, macular disorders)
  • Verifying visual field standards in driver and occupational fitness evaluations
  • Follow-up of medications that may affect the visual field (e.g., long-term chloroquine, vigabatrin)

Preparation

  • Being well-rested before the test improves the reliability of results
  • If you wear glasses, the trial lens recommended by the physician is used; contact lenses may sometimes need to be removed
  • Avoid drops that significantly alter pupil size before the test; if needed, perform them after the examination
  • Be mentally prepared, as you will need to fixate on a single point for approximately 10-20 minutes
  • If you have previous visual field test results, bring them along for comparison

How it's performed

  1. You rest your chin and forehead on the device's supports; one eye is covered, and the other eye is tested
  2. You are asked to fixate on a stationary central point; the device alerts you if your gaze drifts
  3. Lights of varying brightness and size appear in the peripheral field; press the handheld button when you see a light
  4. It is correct not to press the button when you are unsure whether you saw a stimulus; guessing negatively affects the results
  5. Each eye is tested separately, usually 5-10 minutes per eye; total duration may reach 15-25 minutes
  6. You may take short breaks during the test if needed; inform the device operator

Post-procedure

  • You can resume daily activities immediately after the test; no special restrictions apply
  • Your physician evaluates the result by comparing it with previous tests
  • In glaucoma patients, the test is generally repeated 1-2 times per year or at intervals determined by your physician
  • The trend across multiple tests (progression) guides clinical decisions rather than a single result
  • If you experience a sudden expanding shadow in your visual field or sudden vision loss, seek care without waiting for the scheduled follow-up

Risks

  • Visual field testing is non-contact and uses only light; no significant side effects are known
  • Fatigue or mild headache may occur due to the prolonged fixation and concentration required
  • Fatigue, distraction, or inexperience may reduce test reliability; repeat testing may be requested
  • Very advanced age, dementia, or limitations beyond hearing/vision may affect the test's feasibility

FAQ

Is the visual field test painful?

No. The test is completely non-contact and painless. You only need to fixate on a point on the screen and press a button when you see lights; no device touches your eye.

Why was my test result deemed unreliable?

Visual field testing requires concentration and steady fixation. Fatigue, distraction, frequent blinking, incorrect positioning, or guessing can reduce reliability indices. In such cases, the test may be repeated after rest; it is not uncommon for early tests to lack sufficient reliability.

How often should the visual field test be performed in glaucoma follow-up?

Frequency depends on disease stage, progression rate, and treatment response. Generally, 1-2 times per year is common; in patients with suspected rapid progression, more frequent testing may be needed. Your physician determines the appropriate frequency.

Can another test replace the visual field test?

The visual field test evaluates the functional status of the optic nerve and visual pathways; it complements structural tests such as OCT. Combining functional and structural testing offers the most accurate assessment in glaucoma and neurological disease follow-up.