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Editors Selection IGR 16-4

Clinical Examination Methods: Automated kinetic perimetry

Comment by Chris Johnson on:

71424 Reclaiming the Periphery: Automated Kinetic Perimetry for Measuring Peripheral Visual Fields in Patients With Glaucoma, Mönter VM; Crabb DP; Artes PH, Investigative Ophthalmology and Visual Science, 2017; 58: 868-875

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In this paper, the authors assess the relationship between visual field sensitivity for the central 30 degrees radius of the visual field (static perimetry) and the far periphery (kinetic perimetry beyond 30 degrees) in a group of 30 glaucoma patients using the procedures on the Octopus 900 perimeter. Evaluation of the visual field beyond 30 degrees in glaucoma patients was a research topic of interest in the 1970s and 1980s, but there has been little effort directed towards this problem in recent times. As a consequence, the advances in visual field testing have not been applied to assessment of the far periphery. The authors demonstrate that it is possible to have a reliable and efficient method of testing the far periphery using automated kinetic testing. Additionally, they provide examples where there is good agreement between central and peripheral visual fields, as well as cases in which the central visual field is damaged but the peripheral visual field is intact, and vice versa. Because the peripheral visual field is important for navigation, object detection and motion sensitivity, it is refreshing to see this this issue being investigated again. The results of testing the far periphery will provide important information to the practitioner concerning the patient's capabilities for performing activities of daily living and the influence of damage to these visual field areas on quality of life. Although this study concentrated on glaucoma patients, it is clear that quantitative assessment of the far peripheral visual field will be even more important for patients with retinal degenerations or neuro-ophthalmologic problems affecting the visual pathways. Development and refinement of methods to evaluate the far periphery will undoubtedly enhance the practitioner's ability to predict which activities will be affected by impairments the visual system. I applaud the authors for their efforts on this problem.

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