visual field examinations week 6 interpreting of visual fields

Visual field Visual field examinationsexaminations

Week 6 Interpreting of visual fields

Interpreting the dataInterpreting the data

Is it a legitimate defect? ( tech or patient error)

Is the defect in one or both eyes?What part of the pathway is effected

because of the defect shown?Does the VF make sense? (Compared to

the patient complaints and Dx.)Is there another VF to compare with this

VF?

Is this a legitimate Is this a legitimate defect?defect?Technician error

•Wrong corrective lens•Poor instruction to patient•Forgot to patch patient’s eye•Lens holder to far from eye•Doing the wrong test•Entering wrong birthday•Dilating or not dilating pupil•Is it a depression, scotoma, or neurologic defect?

Technician errorTechnician error

Wrong correction lensPupil was dilated 2nd time.


Lens holder to far away from eye. Wrong birth date


30-2 vs central 10 Poor patient instruction- false positives

interpretationinterpretation

Is there a defect in one eye or both eyes?

If there is a defect in only one eye, it will be before the chiasm.

It can be retinal, glaucomatous, or nerveIf there is a defect in both eyes, is it

congruent or incongruent?If both eyes, is it neurological (chiasm and

beyond) or same problem in both eyes ?

Interpretation of Visual FieldsInterpretation of Visual Fields

What part of the pathway has caused this defect?

Both eyes: glaucoma hx? Trauma? Macular degeneration?

Do the defects have horizontal or vertical respect?

Retinal, macular, nerve and glaucoma are considered to be the same problem happening in both eyes.

Defects that happen at or after the chiasm are effecting both eyes, but are a neurologic problem.

Interpretation of visual fieldsInterpretation of visual fields

Pseudotumor causing papilledema Bitemporal hemianopia

Interpreting visual fieldsInterpreting visual fields

Left eye Right eye


4 VF’s, you tell me!Both eyes effected, you tell me what’s wrong!


Right and left eyes both have a problem- What is wrong?

Depression, step or scotoma? Depression, step or scotoma? Interpreting visual fieldsInterpreting visual fields

Interpretation of Interpretation of visual fieldsvisual fieldsDoes this VF make sense?

If the patient came in for a 6 month repeat VF because of glaucoma, does this field match the Dx?

Interpretation of Interpretation of visual fieldsvisual fieldsAre there other VF’s stored in the computer to compare with the most recent VF?

This is a printout of all the VF’s this patient has taken. With this printout of ALL VF’s taken, it is easy to see how the glaucomatous defects have progressed.

If something is out of the ordinary from what you expect- this comparison is a great way to look at all the past VF’s to figure out the problem.

Interpreting glaucomatous field Interpreting glaucomatous field defectsdefects

Generalized depression

Arcuate scotoma


Nasal step Temporal wedge


Nerve fiber bundle, nasal step

Nerve fiber bundle, arcuate scotoma


End stage glaucoma End stage glaucoma

Interpreting retinal field defectsInterpreting retinal field defects

Macular hole Retinal detachment


Retinal scar due to ocular toxoplasmosis

Choroidal rupture after a blunt trauma causing a scar.


Nerve fiber bundle defects OU

Followed after open heart surgery


Diabetic retinopathy Retinal detachment

Interpreting optic nerve field Interpreting optic nerve field defectsdefects

Optic neuritis OUUsually associated with MS, effects both eyes suddenly when this happens.


Optic atrophy VA 20/200 Papilledema OU


AION (anterior ischemic optic neuropathy) You guess now!!!

Interpreting Chiasmal defectsInterpreting Chiasmal defects

bitemporal hemianopiaChiasmal defect, from a pituitary tumor

Interpreting Chiasmal field Interpreting Chiasmal field defectsdefects

Bitemporal quadrant hemianopia

Bitemporal hemianopias at different stages

Interpreting post chiasmal field Interpreting post chiasmal field defectsdefects

Homonymous quadrant hemianopia

Originating from a problem on the right or left side of the brain?

Interpreting post chiasmal field Interpreting post chiasmal field defectsdefects

homonymous hemianopia, which side?

Homonymous hemianopia, which side?

Interpreting visual field defectsInterpreting visual field defects

Now you try… What are these defects?


Try again…. What are these defects?


See…It’s not that hard after all!

You did a great job!

visual field examinations week 6 interpreting of visual fields

Documents

interpreting of visual

interpreting visual

glaucomatous defects

eyeright eye slide

papilledema ou slide

wrong birth date slide

open heart surgery slide

visual field examinations