Visual field

Eye — The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

Also known as: Perimetry, Tangent screen exam, Automated perimetry exam, Goldmann visual field exam or Humphrey visual field exam

Definition

The visual field refers to the total area in which objects can be seen in the side (peripheral) vision while you focus your eyes on a central point.

How the test is performed

Confrontation visual field exam: This is a quick and basic check of the visual field. The health care provider sits directly in front of you. You will cover one eye, and stare straight ahead with the other. You will be asked to tell when you can see the examiner's hand.

Tangent screen or Goldmann field exam: You will sit about 3 feet from a screen with a target in the center. You will be asked to stare at the center object and let the examiner know when you can see an object that moves into your side vision. This exam creates a map of your entire peripheral vision.

Automated perimetry: You sit in front of a concave dome and stare at an object in the middle. You press a button when you see small flashes of light in your peripheral vision. Your responses help determine if you have a defect in your visual field.

How to prepare for the test

No special preparation is necessary.

How the test will feel

There is no discomfort with this test.

Why the test is performed

This eye exam will show whether you have a loss of vision anywhere in your visual field. The pattern of vision loss will help your doctor diagnose the cause.

Normal Values

The peripheral vision is normal.

What abnormal results mean

Abnormal results may be due to diseases or central nervous system disorders, such as tumors that damage or press on (compress) the parts of the brain that deal with vision.

Other diseases that may affect the visual field of the eye include:

What the risks are

The test has no risks.

Special considerations

Your health care provider will discuss with you the type of visual field testing to be done.

References

Piltz-Seymour JR, Heath-Phillip O, Drance SM. Visual fields in glaucoma. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 49.

American Academy of Ophthalmology Preferred Practice Patterns Committee. Preferred Practice Pattern Guidelines. Comprehensive Adult Medical Eye Evaluation. San Francisco, CA: American Academy of Ophthalmology, 2010. Accessed January 17, 2011.

Budenz DL. Visual field testing in glaucoma. In: Yanoff M, Duker JS, eds. Ophthalmology. 3rd ed. St. Louis, MO: Mosby Elsevier;2008:chap 10.5.

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Review date:: February 10, 2011
Reviewed by:: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, Unviersity of Washington School of Medicine; and Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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