Hasan Ali Abbas

Visual Field interpretation

Henson Supra-Threshold

RE: Enlarged blind spot

LE: Arcuate scotoma
- This defect starts approximately 10-15
degrees away from fixation.

Henson Supra-Threshold

RE: Enlarged blind spot

LE: Plot more of a concern as there are a cluster of
missed points
- RE has isolated points

Testing @Higher Threshold = More defects appearing

- Testing @Lower Threshold = Missing potential
defects

Humphrey VFA
- Full Threshold

Defecting respecting horizontal midline therefore the

lesion affecting the inner retina.

Most likely an IBAO as absolute defect throughout the

superior plot

Plot: Superior Altitudinal defect

Humphrey VFA
- Full threshold

Plot: Bi-Temporal Hemianopia

- Most likely a Pituitary Adenoma

Pituitary adenoma presses on anterior chiasm which

contains inferior retina nerve fibres.

Macular sparing is more characteristic further down

in the visual pathway.
 Hasan Ali Abbas

Humphrey VFA
- 24-2 Full Threshold

Plot: Right Homonymous Hemianopia

- w/ macular sparing

Lesion most likely to be at visual cortex due to

macular sparing characteristic.

Blood supply: Posterior Cerebral Artery

Cause: Potential CVA

Dicon Supra-Threshold
- QMP setting @30 degrees of VF.

Tested points: 40

Relative hill -4 suggests that the starting threshold was

4 decibels lower than expected for the Px.

Grey ring around the grayscale plot suggests edge

sensitivity is lower than we expect.
- Relative defect

9 False positives suggest test is unreliable.

Humphrey VFA
- 24-2 Full Threshold

GHT- Glaucoma Hemifield Test outlines asymmetry

between superior and inferior fields

Px not likely to have glaucoma as VF plot congruous,

respecting the vertical midline, and the defect is
extending towards the edge of the plot.

False negative values not much of a concern

PSD- Suggests local irregularity within the field

- A high number shows a significant degree of
localised loss.

Plot: Bi-Temporal Quadrantanopia

- Potential early Pituitary Adenoma
 Hasan Ali Abbas

Henson Supra-Threshold

Plot: Right Superior Quadrantanopia

Location: Optic Radiations (Meyers Loop)

- Right Superior Quadrant = Pie in the sky = Left
side of the brain @temporal lobe

Referral urgency: Px asymptomatic therefore urgency

type- SOON

Humphrey VFA
- 30-2 Full Threshold

LE plot

SITA fast= 3dB steps to get to the threshold point

Arcuate scotoma
- Relative defect

P<0.5% suggests there is less than a 0.5% chance of a

normal Px illustrating the defect at that point.

Lesion: Pre-Chiasmal Inferior Inner retina

Humphrey FDT
- C20 Full Threshold

LE defect just below temporal, horizontal midline is

7dB deep.

RE defect temporally, inferiorly, next to the vertical

midline is 8dB deep.

Arcuate scotoma
- Suggesting glaucoma
 Hasan Ali Abbas

RE absolute defect
- Potential cause is a lens rim artefact.

to avoid…

- If bulky frame, use full aperture lenses.

- Ensure Px frames are closer to the face.
- Use 24-2 instead of 30-2

Nasal step
- Caused by Glaucoma

OD will have a notch on the inferior side.

TD and PD plots looks different as…

- TD shows general area of loss across the
whole field.
- PD shows a localised pattern.

Defect: RE Enlarged blind spot

Referral: Yes routinely

Fixation 13/15XX means that fixation was checked on

15 occasions and 13 times the Px wasn't looking to
where they should have been.
- XX = Unreliable

Plot: Superior Altitudinal defect

Can't be glaucoma as defects extending towards edge

of the plot.

Inferior retina affected.

Potential causes: Retinal Detachment, Artery/Vein

occlusion, or blood supply @ON.
 Hasan Ali Abbas

Threshold values different due to possible learning

effects

Plot: Right Homonymous Hemianopia

- High degree of congruity

Lesion location: Posterior Radiations/ Visual Cortex

No points tested within macular therefore uncertain if

there is macular sparing or not.

Possible condition: ARMD

- Outer retina affected as defect not respecting
horizontal midline.

RE: Central Scotoma

LE: Centracoecal Scotoma

Humphrey VFA Supra-Threshold

Tested points: 81
- Tested 60 degrees of fixation.

Not necessary to wear spectacles as testing the

periphery.

3zone testing is retesting a point with a brighter

stimulus if missed.

Defect: Peripheral ring

- Retinitis Pigmentosa

Px drive? Check binocularly